News 11/17/17

Top News

VA Secretary David Shulkin, MD asks Congress to move $782 million from its 2018 appropriations to get its Cerner implementation underway, starting with an immediate $374 million in reprogramming since that’s the maximum that can be moved in the short term.

Committee chair Charlie Dent (R-PA) and ranking member Deborah Wasserman Schultz (D-FL) opened the session by expressing their frustration with previous VA-DoD interoperability efforts, the failure of the VA and DoD to follow the previous directives of Congress to create a single system, and their skepticism that the Cerner project will run as smoothly as the VA is assuring.

Some comments from Wednesday’s session:

• The committee declined to discuss cost issues in the open session because the Cerner contract has not been signed and the VA is worried about bid protests. Cost was discussed Wednesday in a closed session that followed the public one.
• Shulkin said that modernizing VistA would have cost $19 billion and would only say that the Cerner project will cost billions less.
• The VA said it will save 5 percent of the project’s cost if the money is approved quickly so that the VA can align its project with the DoD’s.
• Wasserman Schultz referred to the VA’s EHR history as, “The unbelievably lengthy process this has been, even for government,“ adding that, “This issue could have and should have been resolved years ago,” and, “It’s no wonder our constituents get incredibly frustrated with the insanity of the bureaucracy of many federal agencies. This is a textbook case.”
• Wasserman Schultz called the DoD’s selection of Cerner as “problematic” with regard to VA-DoD interoperability given that the VA had committed to modernizing VistA, adding that “the patchwork of the Joint Legacy Viewer has left much to be desired.”
• Wasserman Schultz said, “I was not thrilled at getting a $782 million reprogramming at the end of October that needed to be acted on by November with no real details. I’m also concerned about how this new system will work with the private sector providers .. I’m concerned that the VA’s foot-dragging and missteps have become our emergency because DoD has gone forward and jumped ahead to what we should have been doing in parallel … that’s not really the fiscally responsible way to do things.”
• Shulkin reminded the committee that VistA is not a single system, but rather 130 separate systems that cannot continue to function. Those will be shut down one at a time as the Cerner implementation progresses over eight years.
• Shulkin admitted that previous VA IT projects have not been delivered on time and on cost, but said the Cerner project will be overseen directly by the deputy secretary and the DoD’s lessons learned will be invaluable.
• Shulkin said, “We’re taking advantage of the private sector CIOs. Mr. Blackburn’s going to be on a call with five of the leading CIOs in the country, getting their advice, asking what mistakes are likely to happen, and essentially using private sector input. I’ve been a private sector CEO. I’ve done EHR implementations.” Specifically named as being consulted in response to a later question were the CIOs of Mayo Clinic, Partners, Johns Hopkins, and Kaiser Permanente, all of which interestingly use Epic rather than the VA’s no-bid choice of Cerner.
• Shulkin talked up what seems to be CommonWell along with HIEs in response to a committee question about community interoperability, a subject brought up several times by committee members. He added that the VA has just issued an RFI for the Digital Health Platform that will address that issue.
• The VA’s EHR modernization executive director, John Windom, guaranteed 100 percent interoperability with the DoD in response to a committee member’s rather pointed question.

Reader Comments

From Winter Rye: “Re: Medent sale. I’ve never understood its reach despite the apparently success of its family and 8,000 reported deployments. The resignation of the son-of-the-father CEO may be telling that other family members want to sell after the father / founder died earlier this year. Potential buyers?” The family seems to be angrily split on selling the 260-employee EHR/PM vendor, which is based in Auburn, NY. It claims 8,000 physician users, with ONC placing it at #13 on the Medicare EHR Incentive Program most-attested vendor list with just under 4,000 EPs. It’s not the best environment to be selling an ambulatory EHR vendor given that segment’s consolidation, but it’s all about the asking price and the acquirer’s confidence of either maintaining the revenue stream or converting users to their own product (the former is much more likely than the latter). The worst thing that could happen is that the family members can’t agree whether to sell and the product languishes amidst the bickering.

From Allscripts Curious: “Re: the new Allscripts ambulatory EHR showcased at MGMA. Anyone seen it and have feedback? It claims to offer cloud hosting, usability, interoperability, mobility, and embedded AI, but management was short on details.” I’m interested as well. I assume this is the Allscripts Care Otter project, which after I mentioned it via a reader’s tip in August wondering why it wasn’t ready to be shown at ACE, all online traces of the project were immediately taken down. This reminds me of why I’m skeptical when vendors suddenly claim to have embedded the oh-so-trendy AI in their products, leading me to wonder exactly what that means beyond the usual hard-coded programming logic (the real definition of AI is that the system simulates human intelligence in applying what it learns to complete new tasks, which sounds kind of unlikely for an EHR).

From Nice Hat: “Re: patient access technology. What does that mean, exactly?” It’s less noble than it sounds, usually referring to technology that increases the number of profitable patients that can be cranked through the system.

HIStalk Announcements and Requests

Thanks to Healthfinch, which has upgraded its HIStalk sponsorship to Platinum level.

At least 50 percent of the usage of the possessive “its” that I’ve seen lately incorrectly spelled the word as “it’s,” raising the near-certain likelihood that dictionaries will start listing the misspelling as acceptable in their self-assigned role of being descriptive rather than prescriptive.

This week on HIStalk Practice: CDC announces Million Hearts Hypertension Control Challenge winners. GE CEO John Flannery announces major restructuring. Mynd Analytics makes telepsychiatry acquisition. Nomad Health adds telemedicine to healthcare jobs marketplace. Pacifica Labs adds therapist directory to popular mental health app. Forward brings high-tech primary care to LA. The Iowa Clinic embarks on population health management with help from Lightbeam Health. PRM Pro Jim Higgins outlines how PRM tools can help physicians treat the person inside the patient.

Webinars

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Here’s the video recording of this week’s webinar titled “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.”

Acquisitions, Funding, Business, and Stock

Merck-owned Ilum Health Solutions acquires Teqqa — a partner organization that offers analytics for infectious disease analytics — to enhance its antibiotic stewardship offerings with point-of-prescribing decision support.

Patient adherence message vendor ConnectiveRx acquires Pittsburgh-based Careform, which offers technology for specialty drug access.

Hospital and infusion center scheduling system vendor LeanTaaS raises $26 million in a Series B funding round, increasing its total to $39 million.

Banyan Software acquires Atlanta-based student health EHR vendor Medicat. I was puzzled why the company that developed the Vines networking system would buy an EHR vendor, not realizing that Banyan Systems has been defunct for nearly 20 years.

Fast Company profiles Remedy, a shuttered startup that used technology and human billing experts to help people get their incorrect medical bills fixed. The company says hospitals, practices, and insurers wouldn’t cooperate by giving it access to the billing records of their customers, saying in its goodbye message, “Until the industry begins respecting the rights people have to their own information, it will remain difficult for individuals and their agents to be vigilant against baseless medical bill overcharges.” The article acknowledges that perhaps the company should have done more due diligence before placing investor bets on external data access, but adds that the company’s billing subcontractors were buried in paperwork as hospitals and practices required completing manual forms, lost the submitted forms so they had to be completed again, and incorrectly told them that HIPAA made it illegal to work with the company.

AI-powered patient engagement platform vendor Catalia Health raises $4 million in a pre-Series A round, increasing its total to $7.75 million. The company offers Mabu, a supposedly human-like conversational companion whose robotic voice is about as un-human as it can be, making that a good place to spend some of the new windfall.

Sales

Jefferson Health (PA) chooses KyruusOne and ProviderMatch for Access Centers to create and manage a central provider directory that provides visibility into network-wide clinical coverage and provider expertise.

Griffin Hospital (CT) will implement FormFast’s electronic form and workflow technology along with check printing.

In Australia, Royal Adelaide Health chooses the anesthesia information system of Florida-based IProcedures as part of its Allscripts contract.

Allegiance Health Management (LA) selects Medhost’s clinical and financial solutions, EDIS, and YourCareCommunity patient and provider portal for eight of its facilities.

Banner Health will implement Health Catalyst’s Data Operating System for its outcomes improvement program.

People

A UCSD announcement of the go-live of UCI Health on a shared instance of UCSD Health’s Epic system quotes UCSD Health CIO Christopher Longhurst, MD, MS and UCI Health CIO Chuck Podesta.

Protenus hires Megan Emhoff (Curiosity Media) as VP of people operations.

Announcements and Implementations

Apple co-founder Steve Wozniak will headline InstaMed’s 2018 User Conference April 9-11 in Philadelphia.

The Iowa Clinic (IA) goes live on the population health management platform of Lightbeam Health Solutions.

The local paper covers the first US deployment of Netherlands-developed, infection prevention-focused OR Cockpit at Ocean Springs Hospital (MS).

Philips and Nuance will bring AI-based image interpretation and reporting capabilities to radiologists in integrating their respective Illumeo and PowerScribe 360 products.

NextGen adds the IMO Problem IT Terminology diagnosis entry tool by Intelligent Medical Objects to the mobile workflow solution that was part of NextGen’s acquisition of Entrada earlier this year.

Image Stream Medical offers HIStalk readers “Surgery is a Team Sport,” a three-part educational series on improving teamwork, increasing care quality, and expanding efficiency.

In Canada, Canada Health Infoway and OntarioMD will align the privacy and security components of their respective EHR certification programs.

Other

An “internal network infrastructure issue” leaves CVS Pharmacy unable to process prescription refills. Annoyed Twitter users dispute the company’s claim that new prescriptions are being filled normally, saying that the multi-day outage has disrupted all CVS prescription activity and has caused store personnel to suggest they head over to Walgreens.

CHIME suspends its highly publicized, $1 million prize National Patient ID Challenge after two years, saying “a new approach is warranted” with no good solutions found and admitting that “we cannot do this alone.” CHIME President and CEO Russ Branzell also notes that Congress may soften its stance on prohibiting HHS from creating a national patient identifier. CHIME says it will bring together key stakeholders to find a national solution that identifies people with 100 percent accuracy (its million dollars would be safe there for sure).

A woman sues EClinicalWorks for $999 million, hoping to attain class action status in claiming that her husband died because ECW’s EHR left him “unable to determine reliably when his first symptoms of cancer appeared in that his medical records failed to accurately display his medical history on progress notes” without really describing what happened. The complaint cites the certification issues that were listed in ECW’s settlement with the Department of Justice.

In England, a physician’s op-ed piece complains that a private telemedicine provider is advertising itself as a replacement for seeing GPs while excluding more complex patients, thus cherry-picking the easiest ones and threatening GP practices that are paid a fixed $200 per patient per year in which the healthy subsidize the sick. The yearly fees are transferred to telemedicine provider Babylon when a patient signs up for an online visit. The author says his practice can’t provide services to truly ill patients if telemedicine providers skim off the profitable ones:

But while anyone can join its service, the website says it may not be suitable for “complex mental health problems or complex physical, psychological or social needs.” Or if you’re pregnant or older and frail, and as long as you don’t have dementia or learning difficulties or safeguarding issues … We cannot refuse to register patients or advise them to register elsewhere based on age, gender, or disability. If my surgery put a list on its website telling the most ill people in our catchment area we weren’t suitable for them, NHS England would serve us a breach of contract notice and could close us down.

I mentioned that Thursday night’s “Grey’s Anatomy” winter finale involves a hospital cyberattack, with a sneak preview showing that it’s ransomware. It’s a pretty realistic EHR screen and “Tim from IT” gets a fun line before his day is wrecked in cutting off the nurse’s description of the problem by asking her if she’s tried turning the computer off and back on. Hollywood loves playing sounds when text displays on a screen like a teletype and did so here, which might be desirable for ransomware but not otherwise. The hacker appears to be demanding 4,932 bitcoin, making the ransom at bit steep at $38 million.

Sponsor Updates

• Elsevier adds an Opioid Epidemic Resource Center to its Connect website.
• Salesforce offers an e-book titled “How a Mobile CRM Makes You More Successful” and a guided tour of Community Cloud Lightning.
• Datica CTO Adam Leko and Methodist Le Bonheur Healthcare analytics director David Deas will present a session on eliminating HIPAA compliance as a development barrier at the Amazon Web Services AWS re:Invent conference on November 27 in Las Vegas.  
• Brava Magazine profiles Healthfinch VP of Finance and Operations Leah Roe.
• Healthgrades partners with Code.org to bring Hour of Code to schools in Atlanta, Denver, Madison, and Raleigh.
• Healthwise will exhibit at the Next Generation Patient Experience November 28 in San Diego.
• Iatric Systems releases a preview of its forthcoming Security Audit Manager.
• Imprivata customer support wins the 2017 TSIA Star Award.
• The HCI Group partners with the Dubai Health Authority for the DHA Transformation Forum.
• Consulting Magazine includes Impact Advisors in its list of fastest-growing firms for 2017.

Blog Posts

• Hot Topics from Georgia’s 8th Annual Health IT Leadership Conference (Liaison Technologies)
• What is SMART on FHIR? (Redox)
• Are You Ready for Revenue Cycle Consolidation? A 7 Point Checklist (Hayes Management Consulting)
• CIO Chat – Scott Arnold, Tampa General Hospital (Huntzinger Management Group)
• 3 Tips to Become Unbusy (Access)
• 5 Oracle PeopleSoft 9.2 Upgrade Considerations (The HCI Group)
• Genomic Technologies See Strong Investment in 2017 (Healthcare Growth Partners)
• 4 Questions with Cara Babachicos, Senior VP & CIO at South Shore Health System (Optimum Healthcare IT)
• A Healthcare Marketing Analytics Primer: Start with Data (Influence Health)
• Give Thanks for These Payment Security Accomplishments (InstaMed)
• Part 1 and Part 2: Top 3 Reasons Healthcare Organizations Are Investing in Patient Engagement (InterSystems)
• The Patient Access Journey is Changing & Health Systems Need to Respond (Kyruus)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 11/15/17

Top News

American Medical Association EVP/CEO James Madara, MD pitches AMA’s recently announced Integrated Health Model Initiative at the organization’s Interim Meeting. He criticized the poor organization of clinical data sets; the lack of clinical usefulness of EHRs; the need for meaningful interoperability; and “oceans of data, but only puddles of clinical meaning.” His overriding message was that useful information is scattered throughout the EHR, it lacks context, and its needs to include patient-reported data and perceptions.

Meanwhile, AMA President David Barbe, MD cites AMA’s major wins at the same conference in which he urges attendees to recruit new AMA members. “We successfully fought to postpone a mandate for physicians to upgrade their EHRs … We are fighting to prevent IT vendors from blocking information or making it expensive for physicians to share data, and we are making progress. We are fighting physician burnout and the time crunch by working to improve EHRs, mobile devices, and interoperability, and again, those efforts are showing signs of success.”

AMA is protective of its membership count – omitting the actual number from its otherwise detailed annual report — but admits that its small growth in the past few years is due to offering low-dues options to groups and for partial-year trial memberships. Some observers estimate that the percentage of American physicians who are members has dropped from 75 percent in the 1960s to as low as 15 percent today. Most of AMA’s $324 million in annual income is from publishing, selling databases such as CPT codes, and profits from its insurance agency.

Reader Comments

From LinkedOut: “Re: LinkedIn. You said it’s inexcusable not to have a LinkedIn profile. I have found it useful only for networking, primarily to land your next job. Most profiles are outdated. I’m happy in my current position and don’t have a profile. I prefer anonymity and a quiet inbox. If you are in a long-term relationship with someone with an updated EHarmony profile, you’ve got a surprise coming.” I dislike LinkedIn for many reasons: endless spam; slow page load time; user-written vanity pieces; and preening profiles full of questionably accurate credentials. All that aside, I look people up there all the time there for both work and non-work reasons (where did my cousin John Smith ever end up?) My comments specifically referred to executives, where not making a bio and headshot available there is a bad PR move. I also believe that everybody should be open to employment inquiries, which they are free to accept or reject as a business decision unrelated to receiving them in the first place. It’s a lot harder to desperately market yourself after your once-beloved employer has escorted you off their property and your current LinkedIn headline turns into “seeking the next great HIT opportunity” or you declare yourself a first-time, self-employed consultant because nobody’s hiring you. Anonymity and a quiet inbox are great until the paychecks stop, and trust me when I say that your employer’s EHarmony profile is always current even if yours isn’t. 

From Smoove B: “Re: HIStalkapalooza. Since you aren’t doing it at HIMSS18, you can put your name on our company’s event and we’ll give you some invitations to use.” I don’t really see any point to that, but it reminds me of something I’ve always wondered just in case I ever consider doing it again: why did people attend HIStalkapalooza? If you were there, complete this one-answer poll about why and I’ll report back. So far I’m not feeling nostalgia for the massive personal financial risk, the never-ending search for sponsors to help cover the cost, and the ugliness of the self-impressed who insist that their party presence is mandatory. HIMSS has plenty of parties, so mine shouldn’t be missed much.

From Hinrika: “Re: UAE. Thought you would be amused at what happened when I tried to read HIStalk in Dubai this morning.” I’m always happy to be blocked, although it’s best when a paranoid vendor tries to hide unflattering news and opinions from their employees. That usually has the opposite effect — they simply read from home or on their phones out of curiosity to see what their employer wishes they wouldn’t. I don’t know what I wrote that got me banned in the UAE, but I’m probably proud of it.

From GoLiveSupport: “Re: [health system name omitted]. [consulting company name omitted] was chosen to help with its Epic go-live and brought in buses of foreign resources who could not speak English. The health system was so unhappy with the inexperienced resources that they made all of them take an assessment and then immediately walked off all 300 of them off the property and kicked the company off the project entirely.” Unverified and likely to stay that way since neither the health system nor the vendor is likely to confirm, so I’ve expunged the names.

From Timothy: “Re: SOAPware. It’s not new news that the EHR vendor is shutting down effective February 2018, but they’ve sent clients a memo suggesting they transition to Athenahealth. Apparently they had established a marketing agreement that I’m sure Athena paid some good $$ for.”

Webinars

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

ED notification technology vendor Collective Medical raises $47.5 million in a Series A funding round. The Salt Lake City company, founded in 2006 by a couple of BYU computer science graduates, is now run by a Bain Capital private equity guy (and BYU grad) in his first CEO job.

Syapse, which offers an oncology precision medicine and data sharing platform, raises $30 million in Series D financing, increasing its total to $70 million.

Israel-based Medigate, which offers a cybersecurity platform to inventory and protect connected medical devices, raises $5.4 million in a seed funding round. The three co-founders were all officers in the Israeli Defense Forces Intelligence Corps.

Coding and compliance services vendor Aviacode acquires an unnamed, India-based medical coding company to extend its coding staff and available hours.

A state judge denies a request from investors in Outcome Health who had asked the court to freeze $225 million that was due to be paid to the company’s founders. The investors’ lawsuit claims that the doctor waiting room advertising technology company, whose valuation rose to more than $5 billion, defrauded them by falsifying advertiser metrics. The complaint was amended Sunday to note that 22 high-level executives have left Outcome or have been placed on leave so far this year, with the investors also noting that they are receiving Justice Department subpoenas and expect the SEC to get involved. 

People

Healthcare economist Uwe Reinhardt of Princeton University died Monday at 80. His seminal Health Affairs article, “It’s the prices, stupid: why the United States is so different from other countries” pointed out way back in 2003 that we spend more than any other country on healthcare only because healthcare goods and services cost a lot more here, an issue that remains unaddressed by policy-makers fixated with cutting insurance benefits and reducing the number of people able to buy plans (guess who’s got more lobbyists?) 

Humana appoints former National Coordinator Karen DeSalvo, MD, MPH, MSc to its board.

Announcements and Implementations

Meditech announces a cloud-based subscription version of its Web EHR that targets critical access hospitals. The company says hospitals can go live within six months of signing.

A Black Book survey finds that only 19 percent of inpatient post-acute providers have any kind of EHR capability, with 91 percent of administrators reporting that they have no money budgeted for technology acquisitions and improvements. Nearly 90 percent of long-term care providers are not exchanging information with referring hospitals, doctors, or home health providers, while only three percent of them have analytics capability. Netsmart is Black Book’s top-performing post-acute care technology vendor based on user satisfaction.

Casenet releases TruCare ProAuth, which allows providers to process prior authorization requests.

A Change Healthcare study finds that at least 40 states are pursuing value-based payment programs.

UPMC touts its kidney failure detection EHR alert that monitors serum creatinine trends, although the big-picture mortality improvement has been modest.

Mediware adds billing capability to its MediLinks rehab EHR.

Government and Politics

CliniComp offers to drop the appeal of its dismissed lawsuit against the VA – for choosing Cerner in a no-bid contract — if the VA agrees to test its product head to head with Cerner and let the non-partisan General Services Administration judge which system performs best against existing VistA-to-DoD interoperability benchmarks. They don’t have a chance in this political climate, but its offer throws some justified shade on the VA for declaring that it’s in the best interest of taxpayers to sling no-bid billions at Cerner instead of looking at competitors, of which Epic would be a lot stronger than CliniComp despite the former’s lack of success implementing the Coast Guard and bidding for the DoD.  

The DoD’s MHS Genesis will celebrate completion of the initial deployment of Cerner in a Facebook Live event from Madigan Army Medical Center (WA) Wednesday at noon ET.

The VA issues a $158 million contract to CSRA to convert the paper health records of 7 million veterans to digital form as part of its conversion to electronic claims.

Technology

FDA approves the Proteus “digital pill,” a skin patch that will report to doctors when a patient takes a digitally enabled dose of the psychiatric drug Abilify. The system may improve adherence, although no studies have proven that, and it may prevent psychotic episodes if the patient is historically forgetful rather than deliberate in skipping doses. Still, some experts note the irony of giving a “biomedical Big Brother” to delusional patients as well bringing up the privacy implications of being monitored (although patients can opt out). An alternative is already available – once-monthly injectable aripiprazole. 

A London scientist develops a camera that highlights temperature hot spots on the feet of diabetics, allowing early detection of foot ulcers.

Other

A Boing Boing article that contains no new research (but admirable snark) calls IBM Watson for Oncology “a human-driven engine masquerading as an artificial intelligence” that simply relays the results of a manual case review by Sloan Kettering experts. It notes that IBM hasn’t allowed an independent study of how Watson for Oncology works; its misleads doctors into thinking they will get a data-driven, global recommendation instead of the opinion of a handful of peers; it can’t accurately import patient records; and its outcomes haven’t been studied to see if its recommendations are any good.

A research article concludes that “psychological mass persuasion” — using an individual’s digital footprints such as Facebook likes or Twitter activity to target social media advertising that pushes their specific hot buttons — is effective in altering their behavior, measurably influencing their purchasing and voting behaviors. That confirms (to me, anyway) that stories about social media influencing elections miss the most important point – that Americans aren’t smart enough to realize when they are being manipulated, are too lazy or too embracing of information that matches their beliefs to vet their information sources, and are too quick to launch personal attacks at anyone whose opinion (or especially factual information) contradicts what they want to hear. American adults of today sometimes seem like American children of yesteryear – self-indulgently watching cartoons, playing with toys, enviously watching what their friends are doing, and throwing temper tantrums, except now it’s all online. Let’s hope we don’t get invaded since the only resistance will be people getting in the way by holding up phones hoping to post the first Facebook selfies.

An interesting public health issue: Colombian “soda cartels” threaten and attack consumer advocates who support a 20 percent tax on sugary drinks that are cheaper than water, convincing the government to threaten supporters with fines. Colombia’s obesity rate has tripled since 1980. 

A hacker breaches the hospital’s computer system in this Thursday’s “Grey’s Anatomy,” forcing the TV doctors “to get creative in their methods to treat the patients.” I’m certain it will be far from realistic, even omitting the standard hospital executive post-incident assurance that the system that was expensively purchased with claims that it would improve patient care puzzlingly didn’t negatively impact that same care when it tanked.

Sponsor Updates

• PokitDok earns HITRUST CSF certification and accreditation for OSAP-HIE and CEAP.
• Kern Health Systems (CA) goes live on ZeOmega Jiva 6.1.
• LogicStream Health moves into a larger Minneapolis office after doubling its FTE count since 2015.
• Definitive Healthcare is included in Deloitte’s Technology Fast 500 list.
• Meditech celebrates Canada’s Digital Health Week.
• Agfa Healthcare publishes a new white paper, “Augmented Intelligence – The Next Frontier.”
• Black Book’s latest survey ranks Netsmart as the top-rated HIT platform across post-acute settings for the third consecutive year.
• Arcadia Healthcare Solutions and Cumberland Consulting Group will exhibit at the 2017 HPA Clinical Informatics Value Visit November 15-17 in Kissimmee, FL.
• Besler Consulting releases a new podcast, “Healthgrades 2018 Report to the Nation.”
• Carevive will present at the Navigation & Survivorship Conference November 16-19 in Orlando.
• CoverMyMeds will exhibit at the Norcal HIMSS Annual CXO Summit November 16 in Santa Clara, CA.
• Diameter Health President John D’Amore presents the the 2017 Digital Quality Summit.

Blog Posts

• Tips for structuring a successful mobile device pilot (PerfectServe)
• Geography Should not Dictate the Standard of Care: How to Incentivize Telemedicine in the Medical Community (Part 2 of 3) (Leidos)
• Patient Privacy Made Smarter (Iatric Systems)
• Why Do Physicians Use Pagers? (Spok)
• Impressions from ehi LIVE 2017 (Agfa Healthcare)
• 11th Hour, 11th Day, 11th Month: A Veterans Day Thank You (Access)
• Using Technology to Build an Integrated Practice #6 of 6 (AdvancedMD)
• Prepping Your Patients for Year-End (Aprima)
• Digital Health Success Framework: Building a Body of Evidence to Support Your Strategy (Datica)
• 2018 Medicare PFS Final Rule Recognizes Benefits of Telehealth (CareSync)
• Why Everyone is Talking About ChartLogic’s Voice Dictation (ChartLogic)
• Diagnosis and Treatment of Free Text Syndrome (Clinical Architecture)
• From One Organization to Number One! (CTG)
• Three Trends Impacting Recruiting Teams (Dynamic Computing Services)
• In Baseball and Business: “Adapt or Die” (Dimensional Insight)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 11/13/17

Top News

In England, the Migrants’ Rights Network challenges a January 2017 NHS data-sharing agreement that allows the Home Office’s immigration enforcement teams to access confidential patient information.

The Home Office has made 8,000 data requests so far this year, using NHS patient information to target 6,000 people.

New regulations also require hospitals to check a patient’s ID and to verify their ability to pay for services.

Migrants’ Rights Network says the data-sharing agreement violates privacy guaranteed by the Human Rights Act, does not justify breaching the doctor-patient relationship, leaves migrants too scared to access healthcare services, and discriminates against non-citizens. Their challenge is supported by Kingsley Manning, former chair of NHS Digital.

Reader Comments

From Jonathan Baran: “Re: Epic. This past week in Madison, Epic held its first App Orchard Conference and it was a great start to the program. The audience was approximately 300 people, split between  health systems and third-party app companies. Epic has been criticized for being ‘closed,’ but based on my experience this past week, Epic was the opposite. As an app company on the App Orchard, we had access to developers, our own technical service representative to answer any questions (similar to customers), and their roadmap spoke to us getting continued support.” Jonathan is co-founder and CEO of Healthfinch. Another reader who provided the graphic above said Epic announced an “FHIR First” strategy.

From LobbyWin: “Re: UnitedHealth Group. Lobbyists may have convinced the Department of Justice to drop the whistle-blower lawsuit claiming that it bilked Medicare of billions. Their DC team was able to score a similar victory with the previous administration’s DOJ.” A federal judge dismissed the Justice Department’s lawsuit in mid-October and the DOJ has elected not to re-file its complaint, which involved up-coding Medicare Advantage claims.

From Informatician: “Re: Craig Venter’s Human Longevity. Didn’t see this on HIStalk (or anywhere else), but on November 1 the company laid off its chief medical officer and his entire department of at least 15, which includes physician informaticists. The chief scientific officer is leaving as well (voluntarily?) The Health Nucleus thing is in trouble.” Unverified. The San Diego company, which has raised $300 million, offers Health Nucleus X, which collects data from whole genome sequencing, MRI, microbiome sequencing, and other tests that claim to allow consumers to “stay ahead of aging and illness.” The bio page of Chief Medical Officer Brad Perkins has been removed from the company’s website although his LinkedIn profile remains unchanged. The cached version of the executive webpage from June 2017 shows that eight of the 18 names listed aren’t included on the current version of the page.

HIStalk Announcements and Requests

Around half of poll respondents have donated money to a hospital or health system.

New poll to your right or here: should the federal government review AMA’s licensing of CPT procedure codes as a possible monopoly? Vote and then click the poll’s Comments link to weigh in.

This Week in Health IT History

One year ago:

• Cerner CEO Neal Patterson makes a surprise appearance at the Cerner Health Conference, expressing his frustration with the healthcare system from his experience as a cancer patient.
• UCSF and GE Healthcare announce plans to work together to develop clinical diagnosis and management algorithms.
• Cerner says in its earnings call that it expects that its DoD win will give the company a strong competitive advantage if and when the VA decides to replace VistA.
• NTT Data completes its $3.1 billion acquisition of Dell Services.

Five years ago:

• Allscripts CEO Glen Tullman admits in the company’s earnings call that its drastically reduced quarterly earnings were caused by rumors that the company is trying to sell itself.
• PCP usage of EHRs increases to 69 percent.
• WellStar Health System pays $20,000 for the intellectual property of the bankrupt Center for Health Transformation, the for-profit think tank started by Newt Gingrich.

Ten years ago:

• Google releases the Android operating system for mobile devices.
• Mediware retools the company by hiring a new CEO, restructuring, retiring products, and laying off employees.
• Three Medquist board members quit over concerns about the company’s potential sale.
• Sutter Health says its Epic project will cost at least $500 million vs. the initial estimate of $150 million.
• AMIA announces an initiative to establish clinical informatics as a medical specialty.
• IBM acquires Cognos for $4.9 billion in cash.

Last Week’s Most Interesting News

• Insiders say the VA will sign its contract with Cerner this month at a total cost of $10 billion, much less than originally estimated.
• Major investors in Outcome Health sue the company, claiming fraud.
• Saint Anthony Hospital (IL) sues the Leapfrog Group, saying that the quality organization lowered its patient safety grade based on incorrect data.
• UPMC (PA) announces plans to spend $2 billion to build three technology-focused specialty hospitals in Pittsburgh.
• A former employee of WakeMed (NC) files a whistleblower False Claims Act lawsuit claiming that Epic’s software defaults to double billing for anesthesia.

Webinars

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

NantHealth announces Q3 results: revenue up 5 percent, EPS –$0.20 vs. –$0.22, beating earnings expectations but falling short on revenue. The company said in the earnings call that its previous sale of its provider / patient engagement solutions to Allscripts will reduce annual operating losses by $50 million.

Sales

Memorial Sloan Kettering Cancer Center (NY) chooses Cota to create optimized clinical and genomic datasets from anonymized patient data, allowing it to map EHR data into a structure that can be used for analytics and precision medicine.

People

Great River Health Systems (IA) names Matt Wenzel (St. Luke’s Health System) as president and CEO. He’s a former Cerner marketing manager with master’s degrees in health administration and healthcare informatics.

Other

In India, a government hospital suspends a doctor who posted on Facebook that the hospital is overwhelmed with dengue fever cases, an outbreak the government has downplayed. The opposition party says the government has asked doctors not to indicate dengue as a cause of death. The 62-year-old doctor says it’s unfortunate that he was suspended since he would have retired at 60 had the government not extended the retirement age of doctors.

St. Vincent Hospital (IN) will use high-tech, vehicle-mounted cameras to match license plate numbers of cars parked in visitor spots with an employee database to enforce visitor-only parking rules, hoping to improve its patient satisfaction scores.

Sponsor Updates

• T-System employees pack over 27,000 meals for North Texas residents while helping out at the North Texas Food Bank.
• Ernest Health implements Cantata Health’s Optimum Referral Portal to standardize the intake process at 18 of its 25 post-acute care facilities.
• Cumberland Consulting Group is named to Consulting magazine’s list of fastest-growing firms.
• TriNetX achieves ISO 27001:2013 certification.
• Verscend Technologies will exhibit at the NHCAA Annual Training Conference November 14-17 in Orlando.
• Vocera publishes new research on clinician burnout and care team resilience.
• ZappRx will exhibit at the Comprehensive Lung and Breathing Summit November 16-18 in Colorado Springs, CO.
• MDwise upgrades to ZeOmega’s Jiva 6.1 population health management platform.

Blog Posts

• How AI Can Help Everyone Do More: An AI Discussion with Suchi Saria (Salesforce)
• Healthcare Mergers and Acquisitions will Change the Future (The SSI Group)
• 7 Automated Healthcare Processes to Improve Practice Productivity (Solutionreach)
• What Aesop’s Fables can teach us about quality improvement (Verscend Technologies)
• Optimal on-call scheduling meets efficient care team communication. (Voalte)
• West Salutes Our Veterans (West Corp.)
• Attracting, Retaining, and Engaging Patients Through Thoughtful Customer Management (WiserTogether)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 11/10/17

Top News

An FCW source says Cerner and the VA have agreed on a rough price of $10 billion for implementing Cerner, with the contract still on track to be signed sometime this month. The price is lower than previously suggested. VA Secretary David Shulkin is reportedly lining up Congressional funding this week.

The initial VA launch, planned for mid-2019, will take place at sites in Oregon, Washington, Idaho, and Alaska.

A federal judge who previously dismissed CliniComp’s lawsuit in which the company claimed it was unfairly eliminated from consideration to replace VistA claims in newly unsealed documents that CliniComp would not have been a credible bidder because it lacks experience with projects of the VA’s scope. CliniComp says it will appeal while seeking an injunction to stop the project.

The judged also noted that she sees no evidence to support the VA’s no-bid choice of Cerner. Other bidders can protest once the Cerner-VA contract is signed.

Reader Comments

From Nordic Employee: “Re: Nordic. Laid off over 10 percent of the home office staff yesterday.” Unverified. Another reader reports that around 15-17 employees were escorted out. I asked Nordic and received this response from CEO Bruce Cerullo:

On Tuesday, Nordic initiated its 2018 growth plan, which includes the further expansion of our Managed Services division, a formal move into non-Epic legacy support, a further investment in our revenue cycle and data and analytics capabilities, and the launch of an ERP practice. As part of this plan, we took the difficult step of restructuring our home office. This included the displacement or redeployment of 17 employees. We recently posted 20 new positions and plan to add up to 150 new employees over the next nine months.

From SoCal Girl: “Re: UC Irvine Medical Center. Went live on Epic on 11/4. Possibly the first site to run out of another’s data center (UCSD) and using a lot of their build. UCI started with TDS in 1983 and stayed through the incarnations (Alltel, Eclipsys, Allscripts) with their own data center until now. Haven’t heard how it’s going.”

From Skippy Trip: “Re: photos. Why do some items in the ‘People’ section not include photos?” I’m always surprised in this day and age how many photo faux pas I see every day when scouting the Internet for headshots since you would think people would want to make it easy to get exposure. Some executives don’t have any Internet-discoverable photos, making me wonder if they have appearance issues or fears of being judged (which they will be anyway, as in, “what’s with the lack of a photo?”) What I sometimes find when I look for headshots:

• People who don’t have a LinkedIn profile, which is inexcusable.
• LinkedIn profiles that don’t include a photo, which is bizarre for someone who works in a people-facing role (you must be a crappy salesperson if your LinkedIn doesn’t include a photo so people can find acknowledge that it’s you).
• Poorly resized LinkedIn photos that are low-resolution or too small, making the pixelated mess unusable even at a small size. LinkedIn shrinks to thumbnails, so there’s no need to downsize the original to their displayed image size.
• Trying to repurpose a vacation photo or family picture in which the grainy subject is surrounded by the shoulders of cropped-out others; is so far from the camera as to be unrecognizable; is wearing a tuxedo, Santa suit, or a bike helmet; or is proudly displaying something alcoholic.

HIStalk Announcements and Requests

I’ve noticed that Twitterers who were dull, clueless, or eye-rollingly self-promoting in their allotted 140 characters are now four times more so with the limit doubled to 280.

This week on HIStalk Practice: Georgia Partnership for Telehealth achieves school-based milestone. Family Christian Health Center selects Visualutions billing software. State-based physician health programs help addicted doctors recover – successfully. Consumers still prefer phone-based appointment scheduling. The Federation of State Medical Boards tests blockchain for the medical licensure process. Alpine Investors takes over behavioral health EHR vendor. Physician pirate Jay Saux, MD brings healing and whimsy to cancer care. Navicure’s Kermit Randa offers practical steps for practices looking to offer digital payment options.

Listening: new from Chicago throwback indie band Twin Peaks. Then it was off to very Canadian jangle rockers Alvvays with the amazing singer-songwriter Molly Rankin (who kind of looks like Veronica Mars), the best thing I’ve heard lately, with extra points for the bass player rocking a Hofner violin end everybody seeming to be delightfully nerdy. I can’t take my eyes or ears off them. “Archie, Marry Me” is one of the best pop songs ever and their live version is flawless (warning: I couldn’t get it out of my head and have listened to it 25 times today).

Webinars

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Here’s the recording of this week’s webinar titled “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.”

Acquisitions, Funding, Business, and Stock

Investors that include heavyweights like Goldman Sachs and Google sue waiting room advertising company Outcome Health, claiming that the company committed fraud in obtaining $500 million in funding by providing false information. The lawsuit was driven by a Wall Street Journal investigation from last month that concluded that the company was inflating the number of video screens it had installed in practices, allowing it to overcharge drug companies, its primary advertisers. Outcome Health calls the lawsuit “irresponsible” and a “money grab,” which is an interesting approach to investor relations.

Sales

Goshen Health (IN) chooses CloudWave’s OpSus Live infrastructure-as-a-service to host its Meditech 6.16 system.

The board of Ector County Hospital (TX) approves implementation of IllumiCare’s EHR-agnostic Smart Ribbon to encourage the appropriate use of tests and drugs. 

WellStar Health System (GA) chooses Agfa HealthCare Enterprise Imaging.

Announcements and Implementations

A small study finds that hospitals that use Glytec’s Hospital-to-Home discharge insulin program for poorly-controlled diabetics had zero diabetes-related readmissions or urgent care/ED visits within the first 30 days after discharge.

Marshall Medical Center (CA) goes live on Epic via a Community Connect agreement with UC Davis Health. The local paper’s article notes that all area health systems use Epic other than Cerner customer Dignity Health.

Humana sponsors an innovation challenge to make the digital health records of Medicare recipients more useful to those patients, their caregivers, and their doctors. California-based individuals and early-stage startups will assemble Humana-provided complex data sets (claims data, hospital records, and health program participation information) into a solution that targets either providers or patients in improving quality or reducing cost. The winner gets $10,000.

A West survey finds that more than half of Americans delay paying their medical bills, with the top reason being high insurance deductibles. Other reasons include forgetting to pay, confusion about what charges insurance will cover, and receiving bills for services they don’t think they should have to pay for. Three-quarters of respondents say high deductibles affect how often they see their provider or seek care. Less than 25 percent of providers discuss affordability in advance, send payment reminders, or provide messages explaining what portion of their bill is covered by insurance.

An Anthem study finds that total joint replacement patients enrolled in HealthLoop’s guidance and monitoring platform cost $656 less and had about half the rate of 90-day surgical complications and readmissions.

Government and Politics

The federal government awards Apprio a contract to transition the DoD’s MHS Genesis system to the Defense Health Agency’s long-term sustainment office.

An editorial in the St. Louis paper rips into the state’s government for refusing to confirm that its cobbled-together prescription drug monitoring program is actually running. Missouri – the only state without a PDMP – created an odd version of its own that relies on claims data to allow government officials to identify “pill mills” but without allowing prescribers to see individual patient data. The governor said in July that the program would be operational in weeks, but the state hasn’t even signed a contract to create it.

HHS announces advance care planning technology vendor Vynca as winner of its Patient Matching Algorithm Challenge, with data integration vendor Pic-Sure earning second place along with wins in the “Best Recall” and “Best Precision” categories.

President Trump’s “Putting Our Veterans First” announcement includes technology references:

• Criminal investigations of the VA’s previous manipulation of wait time data.
• Expansion of the VA’s telemedicine program to span geographic areas.
• Greater adoption of VA Video Connect mobile app.
• Rollout of the VA’s Online Scheduling Tool.
• The move to Cerner for both the VA and DoD.
• Launch of an online wait time tool.

Other

A former employee of Kansas City, MO-based Healthy Plus LLC – run by two locally prominent sports figures – says employees went weeks without pay as the company issued bad checks and closed its accounts. One of those executives previously ran VC Medical, which is the subject of a lawsuit over an unpaid loan. The company is a pilot member of Athenahealth’s More Disruption Please program, offering solutions for chronic care management and Medicare Annual Wellness Visit reminders. A Healthy Plus press release says the business was launched in April 2017.

An Axios article questions UPMC’s plan to spend $2 billion to build three specialty hospitals without adding new bed count, noting from experts that:

• Non-profit hospitals spend big money to erect impressive buildings that entrench their market position, often using tax-exempt debt for buildings on which no property tax is paid.
• The kind of new treatments UPMC aims to discover are revenue-maximizing.
• UPMC is investing in inpatient bricks and mortar instead of what the market is demanding: community-based care, primary care, and home care.
• Pittsburgh residents and federal taxpayers will foot the bill in the form of higher premiums for private insurance, Medicare, and Medicaid.
• Moving patients into a specialty-specific hospital ignores their other conditions and impedes care coordination.

This is a great graphic from Gartner that shows the level of analytic maturity.

AnMed Health (SC) lays off 94 employees and eliminates 65 open positions, citing losses due to lower payments, reduced volumes, and the cost of its $85 million Epic implementation.

Here’s rare video snippet of Epic’s Judy Faulkner speaking, this time at a Geisinger symposium. The moderator didn’t ask great questions or press her for deeper answers, eliciting basically that she likes AI and telehealth. Hopefully the conversation was better than this excerpt.

Pope Francis expresses frustration with people who screw around with their phones when he is celebrating Mass, suggesting they life their hearts instead of their devices. He wrote in 2015, “When media and the digital world become omnipresent, their influence can stop people from learning how to live wisely, to think deeply, and to love generously. In this context, the great sages of the past run the risk of going unheard amid the noise and distractions of an information overload.”

Sponsor Updates

• MModal supports the migration of FHN (IL) to Meditech’s Web EHR with its Fluency Direct speech recognition solution.
• MedData’s Pulse intranet wins the EHealthcare Internet Award for Best Intranet.
• Meditech will present at the Value-Based Care Summit November 16-17 in Boston.
• Medicomp Systems releases a new e-book, “Clinical Conundrum: Too much data, not enough meaning.”
• The Metro Atlanta Chamber of Commerce honors Navicure with its Phoenix Award for Emerging Company of the Year.
• Nordic’s 800 employees and 200 customers are poised for significant growth in 2018.
• Consulting Magazine names Impact Advisors to its list of fastest-growing firms.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Northwest AHEC conference November 14-15 in Hickory, NC.
• Experian Health will exhibit at HFMA Southern IL November 16-17 in O’Fallon.
• Vocera earns Authority to Operate from the DoD.
• The Tech Tribune includes PatientSafe Solutions in its top 10 list of best tech startups in San Diego.

Blog Posts

• Geography Should not Dictate the Standard of Care: How to Incentivize Telemedicine in the Medical Community (Part 1 of 3) (Leidos)
• Create a Consistent Customer Experience Through Your Hospital Contact Center (Spok)
• Customize Your Theme with a Course Catalog (Learn on Demand Systems)
• Is the Digital Revolution Passing You By? (Liaison Technologies)
• Welcoming new members, deployment strategies key themes at the 2017 CommonWell annual general meeting and fall summit (Meditech)
• The CY 2018 MPFS & QPP Final Rules: What You Need to Know (National Decision Support Co.)
• Consider These Gardening Tactics to Drive Billing Team Success (Navicure)
• How Yale New Haven Health used Experian Health solutions to tackle patient financial care (Experian Health)
• Four Questions Series: Dr. John Glaser, SVP, Population Health, Cerner, PatientPing Board Member (PatientPing)
• Physician Collaborators Wanted (PatientKeeper)
• The Rising Costs of Prescription Drugs: How Pharmacy APIs can Improve Transparency (PokitDok)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 11/8/17

Top News

Saint Anthony Hospital (IL) sues The Leapfrog Group for defamation after the quality rating organization lowers the hospital’s patient safety score from its previous A grade to a C.

The hospital says Leapfrog gave it a low score for underusing electronic prescribing even though the information it submitted showed that doctors order medications electronically 95 percent of the time.

Saint Anthony is demanding a temporary restraining order to keep Leapfrog from publishing its score. Leapfrog’s fall 2017 report that was released October 31 does not include the hospital.

Reader Comments

From CIO Reader: “Re: Citrix maintenance price hikes. I don’t have the details, but our maintenance fees will increase nearly 30 percent.” My rule of thumb for companies selling to hospitals has always been that you shouldn’t raise your prices beyond the average Medicare reimbursement increase, although bigger, richer non-profit health systems spending millions and billions to erect monuments to themselves has converted me to being OK with vendors sticking it to them just like any other business. Hospitals will always find a way to increase volume or reimbursement to cover their ever-swelling expenses.

From Grammar Guru: “Re: the HIMSS-owned rag. Needs some help with plural vs. possessive.” Apparently the Healthcare IT New’s editor’s have problem’s with apostrophe’s gone astray.

From Bruce Brandes: “Re: Graysky’s comments about Lucro’s ownership interest and my Readers Write articles. Our company is owned by Martin Ventures, HCA, and Heritage Group. The first priority of the health systems in our network is to reduce costs and inefficiencies to find, evaluate, and choose solutions. While our investors are excited for their portfolio companies to leverage Lucro as a targeted, effective alternative to traditional sales and marketing tactics, their companies have no greater advantage over any other company in Lucro beyond the merits of their own value proposition. There is no cost for any vendor or health system to engage in Lucro and premium services are optional.  Our goal is to level the playing field by democratizing access to relevant buying decisions and there is no Lucro-sponsored opinion or recommendation of one company over any other. We provide a platform for the market to make those assessments on their own, with private support from their invited network of trusted peers. Of the 1,200+ vendors currently engaged with Lucro, about 20 are backed by our investors.”

From Broadcom Insider: “Re: Broadcom’s $130 billion offer to acquire Qualcomm. Last week Broadcom’s CEO promised Trump he would move its headquarters from Singapore to the US. This is an easy way to accomplish that – San Diego, here we come! I wonder what will happen with Qualcomm’s Capsule Tech? Will Broadcom want to get into the healthcare market or remain narrowly focused on semiconductors and chip sets? Attached is a teardown of the new Apple Watch, which contains mostly Broadcom and Qualcomm chips. Clearly the deal makes a great deal of sense.” Experts say the biggest challenge with the blockbuster deal will come from China, which, like the US, looks closely at proposed deals that could shift technology sales offshore. It’s always interesting when a smaller company (Broadcom, $18 billion in annual sales) bids on a larger one (Qualcomm with $22 billion). Qualcomm Life includes Capsule medical device integration (acquired in September 2015 for an undisclosed price) and 2net remote monitoring. Qualcomm Life previously acquired HealthyCircles for data sharing, but that seems to have been either killed off or rolled into 2net. If the acquisition goes through, it would seem both easy and advisable for Broadcom to sell the Qualcomm Life business to a company more focused on healthcare, perhaps Philips or even Nokia.

HIStalk Announcements and Requests

Lorre is running her year-end special for new HIStalk sponsors – avoid the pre-HIMSS rush, sign up now, and get the rest of this year free. She’ll also offer a deal to wayward former sponsors who want to return to the fold.

Listening: new from Kesha, who has matured individually as a singer-songwriter at 30 (even removing the “$” in her name) and, more importantly, musically, with less Auto-Tuned dance pop and more pure rock in her first release since 2013. Her latest album features tracks with Eagles of Death Metal, the horn section of the Dap-Kings, and Dolly Parton, which is a pretty eclectic group.

Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Clinical Architecture will expand its 52-employee Carmel, IN headquarters, more than doubling its square footage and adding 40 jobs by 2021.

CoverMyMeds will hire “hundreds” of support team employees immediately for its Columbus and Cleveland offices. The 500-employee company, which has annual revenue of more than $100 million, was acquired by McKesson in January for $1.1 billion.

Salesforce and Google will integrate Google’s analytics and office software with Saleforce’s platform and Salesforce will use Google’s cloud infrastructure for some of its new services. 

Cardinal Health fires CEO George Barrett after a poor quarterly report due to lower generic drug prices and the Amazon threat, promoting the CFO to the top chair.

CVS Health, fearing competition from Amazon, announces plans to offer free, next-day prescription delivery nationwide next year, with same-day service available in some urban areas.

Roman, which offers online diagnosis and treatment of erectile dysfunction, raises $3.1 million in a seed funding round. Customers choose their preferred drug if desired, pay $15 for a five-minute online visit, then receive home delivery of their med. The company serves men in California, Florida, New York, and Pennsylvania. Drug prices range from $2 for a 20 mg generic Viagra tablet to $63 per tablet for brand-name Viagra.

Kaiser Health News profiles Comprehensive Pain Specialists, a 54-clinic pain treatment practice headquartered in Tennessee that raked in $11 million from Medicare alone in 2014 for urine drug screening. The article notes that Medicare pays tens of millions of dollars for tests that detect drugs that have minimal abuse potential and for screening street drugs that are rarely found in the urine of pain patients. Analysis found that 31 pain practitioners earned 80 percent or more of their Medicare payments just from urine testing, which the government sees as a red flag that perhaps testing is overused, especially as labs increased revenue by moving testing to more expensive machines that earned higher CMS payments. It notes a company that was exposed in a 2011 whistleblower lawsuit as earning $166 million from Medicare for urine screening in a single year, with reps earning up to $700,000 to convince doctors that “drug testing is not about medicine, but about making money.”

Sales

In Australia, publicly funded health service Gippsland Health Alliance chooses Allscripts Sunrise.

In the UK, Princess Alexandra Hospital selects Agfa HealthCare’s enterprise imaging platform.

Amita Health (IL) will implement PerfectServe’s enterprise clinical communication and collaboration system.

Non-profit health plan AlohaCare (HI) chooses Health Catalyst for population health, accountable care, financial decision support, and operational performance improvement.

People

Erik Smith (UnitedHealth Group) joins Stanson Health as RVP of sales.

Former Rent-A-Center CIO Angela Yochem joins Novant Health (NC) in the newly created position of chief digital officer, where she will report to the president and CEO.

Huntzinger Management Group hires David Tucker (ESD) as VP of business development.

Richard Walsh (Continuum Health) joins HealthHusk as managing partner.

BetterDoctor hires John Steinhouse (Box) as VP.

Announcements and Implementations

Surescripts will offer real-time, patient-specific prescription pricing and benefit information to users of EHRs from Allscripts, Aprima, Cerner, Epic, GE Healthcare, and Practice Fusion for patients whose prescription benefits are managed by CVS Health or Express Scripts. Prescribers will also receive therapeutic alternative suggestions within their EHR workflow and can complete any needed prior authorization during the patient’s visit. Surescripts got its start in 2001 as RxHub, formed by three pharmacy benefits managers (Caremark, Express Scripts, and Medco Health) that ended up as CVS and Express Scripts.

The Tiger Institute Health Alliance HIE (MO) joins the Sequoia Project EHealth Exchange, allowing University of Missouri Health Care to exchange information with St. Louis-based SSM Health. 

A Kyruus survey finds interesting facts about consumer provider preference:

• While most consumers search for providers on the Internet, they would rather schedule appointments by telephone.
• 90 percent of people look up providers to whom they have been referred before scheduling their appointment, most of them preferring to use generic Internet searches rather than checking health system websites.
• Among the most important factors in choosing a provider are insurance accepted, clinical expertise, and appointment availability.
• Over 60 percent of consumers will choose a different provider if they can’t get a timely appointment with their first choice.
• 40 percent of people say they trust online reviews.
• Millennials are most willing to choose a different provider because of availability and to schedule their appointments online.

AMIA announces its unspecified collaboration with the OpenNotes initiative.

Government and Politics

University of Vermont Health Network (VT) files a state certificate of need to spend $150 million to implement Epic. The health system says it would save money because Epic would replace systems that would cost $200 million to maintain over several years. CIO Adam Buckley, MD, MBA says Epic is a good choice because it is widely installed and it completes its projects on-time and on-budget 87 percent of the time, while the health system’s choice of project management firm, Cumberland Consulting Group, has a 100 percent success rate.

The VA retools its provider inbox to strip out low-value clinical alerts and trains its doctors to process their messages optimally, with the changes saving clinicians 90 minutes per week.

CMS Administrator Seema Verma says the federal government will “reset the federal-state relationship” in proposing Medicaid reforms that allow states to set some rules of their own and to waive the requirement that states report the health outcomes of such changes. The statement’s wording suggests that CMS is happy to consider state-mandated employment, drug testing, and lifetime coverage limits for recipients. Verma said in her prepared remarks that Medicaid consumes 29 percent of state budgets at a cost of $558 billion; that one-third of doctors won’t see Medicaid patients; and that ACA expensively moved many less-vulnerable people – some of them able-bodied and working – into the program, leading to problems with access and quality, adding that “we shouldn’t just celebrate an increase in rolls or more Medicaid cards handed out.” She said the days of a “tragic example of the soft bigotry of low expectations” are over. Verma used the term “able-bodied” four times in her remarks. 

The owner of a Florida compounding pharmacy pleads guilty to earning $100 million by fraudulently billing insurers $633 million, mostly for pain and scar creams prescribed by doctors who were given kickbacks. The government recovered $7.6 million by seizing the owner’s antique car collection and a 50-foot racing boat. The FBI arrested eight Florida residents in mid-2016 for their role in the scheme.

NIH buys 10,000 Fitbits — hopefully at a significant quantity discount — for participants in its All of Us project that will gather anonymous health information from up to 1 million Americans.

Other

The South Australian government spends $38 million to upgrade its Allscripts-powered EPAS system, raising the total cost of the project to $361 million vs. the originally budgeted $312 million.

IBM proposes that the government of British Columbia use a blockchain system to protect consumers by monitoring the legal distribution of cannabis from seed to sale.

The American Psychological Association’s “Stress in America” survey finds that more than half of respondents – even those who remember World War II, the Vietnam War, and the September 11 terrorist attacks – say the US is at “the lowest point in our nation’s history.” The #1 stressor by a considerable margin is healthcare. APA says a key problem is that people check news sites and social media nearly constantly even though they don’t trust the media and aren’t encouraged by what they see. Perhaps this directly contradicts the “broadband as a social determinant of health” technology fanboys.

A JAMA report creates a healthcare “Affordability Index” that divides the mean cost of an employer-provided family insurance plan by the median household income, which finds that families spend nearly one-third of their income just to pay health insurance premiums. The situation is likely far worse since the income used in the index appears to be pre-tax, high deductibles mean that total healthcare expense is a lot higher, the index looks only at people who buy employer-sponsored insurance, and many people don’t even bother buying insurance since they can’t afford the premiums or deductibles. I remember doing a similar calculation in predicting that the housing bubble had to burst – more homes were being sold (mostly on speculation, as it turned out) than there were people to live in them and the average cost was many multiples of the average household income in the areas that were experiencing the biggest construction boom, strongly suggesting that the music would eventually stop and somebody would be left holding the bill (taxpayers, as it nearly always turns out).

Several hospitals in drug-ravaged West Virginia file a class action lawsuit against the Joint Commission, claiming that its “fifth vital sign” pain management standards downplayed addiction risk and were biased because opioid-selling drug companies helped create them and also supported the Joint Commission financially.

A digital health report reviews the “evidence and impact” of digital health tools, but looks at questionable metrics such as the number of available apps, app store ratings, and the number of downloads. More relevantly, it notes that 571 studies have proved some degree of clinical evidence, 860 clinical trials that use digital health tools are underway, and emphasis is shifting to chronic condition management. It attempts some faith-leaping extrapolation in throwing out a potential $46 billion US cost savings figure if apps were used more widely. The study’s publisher is IQVia, the newly renamed (as of Monday) QuintilesIMS. 

Ambulatory EHR vendor DrChrono enables its app to use the iPhone X’s Face ID facial recognition technology for user log-on.

Sponsor Updates

• AdvancedMD will exhibit at the American Academy of Ophthalmology conference November 11-14 in New Orleans.
• Arcadia Healthcare Solutions will exhibit at the Millennium Alliance Summit November 13-14 in Dallas.
• Besler Consulting releases a new podcast, “Enterprise risk management during healthcare change.”
• Hyland Healthcare — fresh off its acquisition of Lexmark’s Perceptive VNA, content management, and imaging business — will demonstrate its PACS, VNA, diagnostic imaging viewer, and unstructured data viewer at RSNA.
• CoverMyMeds will exhibit at the NG Healthcare Summit November 8-10 in Braselton, GA.
• Forward Health Group founder and CEO Michael Barbouche will present “What Technology means to the BioHealth and Healthcare Industry in Wisconsin and Beyond”at the HHS SMIR/STTR conference in Milwaukee, WI on November 9.
• Visage Imaging will demonstrate its enterprise imaging platform at RSNA.
• Dimensional Insight will exhibit at the HIMSS NE Northern Maine Day Conference November 9 in Brewer.
• Elsevier Clinical Solutions nursing executive Tiffany Mccauley, RN discusses the role of technology in the patient experience during the US News Healthcare of Tomorrow conference in Washington, DC.
• EClinicalWorks will exhibit at the Kentucky Primary Care Association Conference November 8-10 in Lexington.
• The HCI Group becomes a CHIME Global Partner.
• HealthCast will exhibit at the Idaho Chapter HIMSS Conference November 13 in Boise.
• Madison Magazine recognizes Healthfinch as a trailblazer in the field of healthcare innovation.
• InterSystems will exhibit at the Millenium Healthcare Providers Transformation conference November 13-14 in Dallas.
• ConnectiveRx publishes a new white paper, “Optimizing brand access strategies with wrap-around prescriber messaging.”

Blog Posts

• Using Technology to Build an Integrated Practice #4 of 6 (AdvancedMD)
• Geography Should not Dictate the Standard of Care: How to Incentivize Telemedicine in the Medical Community (Part 1 of 3) (Leidos)
• Badass Women in Health Tech: Ida Tin, Co-Founder and CEO of Clue (Redox)
• Health 2.0 Lunch & Learn Recap: What does the success of digital health look like? (Datica)
• Developing a Super User Program that Works (Optimum Healthcare IT)
• Guess Whose ESignature Solution Meditech Uses? (Access)
• Intrinsic and Extrinsic Physician Motivators to Consider When Driving Change (Culbert Healthcare Solutions)
• The Case for Unlimited PTO (Direct Consulting Associates)
• 3 Lessons in Implementing Healthcare Data Governance (Dimensional Insight)
• Seeing the Light on Risk-Based Auditing: A Real-World Example (Hayes Management Consulting)
• Blockchain in Healthcare (The HCI Group)
• MIPS Information Blocking: Attestation Requirements (Impact Advisors)
• New Medicare Card is just like other big changes CMS has made, right? (Imprivata)
• Your VP of Patient Experience Needs a Seat at the Revenue Cycle Table (Influence Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 11/6/17

Top News

UPMC will spend $2 billion to build three new Pittsburgh specialty hospitals for heart and transplant, cancer, and vision restoration and rehabilitation.

UPMC calls the new facilities “digitally-based specialty hospitals.” Microsoft is also working on the project in an unstated capacity, with a goal of changing “what today is often a disjointed and needlessly complex experience for patients and clinicians.”

UPMC says it will reallocate existing beds to the new facilities. The Pittsburgh market has an excess of inpatient beds.

UPMC declared itself as “the global destination for outstanding healthcare” in its announcement, in which it also states its aspiration to become “the Amazon of healthcare.” The 39-hospital, 80,000-employee UPMC also predicts it will double in size within five years. Its annual revenue is $17 billion.

Reader Comments

From Jingle Pockets: “Re: the JP Morgan Healthcare Investor Conference in January in SF. What are the best digital health parties?” I’ve never been invited or attended that conference since it’s for JP Morgan clients only as I understand it, so I can’t help. However, I’m sure some readers have been there and might offer suggestions.

From Skilly Litigator: “Re: Citrix. Do you think most hospitals are aware of the software pieces-parts on which they rely daily or do they believe vendor claims that they wrote everything in-house? Do contracts require the big vendors to disclose the third parties whose solution their products require? Do customers ask for specific details about their rights as a sub-licensee? At least one vendor had their reliance on previously undisclosed third-party components disclosed in a lawsuit relating to sublicensing agreements. What happens if the parties go their separate ways or if a once-removed sublicensor retires their product?” Most clients would be aware of expensive third-party components like Citrix, Cache, or drug databases, but probably less so of free and possibly invisible components. Vendor developers use a lot of tools that could be sunsetted, while products that run on servers (web or otherwise) assume that the components they require will be around forever. Perhaps readers would be interested in a webinar on the topic – I’m open to suggestions. I don’t want to be an alarmist if few problems have cropped up related to third-party software components, but maybe it’s a bigger exposure than I assume. I haven’t received confirmation that Citrix hiked their license fees significantly as one hospital executive reported here previously. 

From Graysky: “Re: Lucro. Consider asking Bruce to disclose ownership interests to your readers when he’s publishing Readers Write articles. Several of the Nashville hospital operators have direct equity in Lucro, which is nothing more than a way for these hospital operator executives to advertise vendors that they have a personal ownership interest in through Lucro. CHS and Lifepoint contribute to the Heritage Innovation Fund, which provides VC funding to many of the vendors that advertise on Lucro. Lucro has already raised a round of funding with Heritage.”

From Cherokee People: “Re: Columbus Regional Health Physicians (IN). Went live on Epic at most of its affiliated and owned physicians offices Wednesday. The hospital is a Cerner shop and has been for a few years now. I’m not aware of any practices affiliated with or owned by Columbus Regional Health that implemented Cerner’s ambulatory solutions.”

HIStalk Announcements and Requests

Poll respondents say GE Healthcare has taken the biggest ambulatory EHR fall, although the other vendors listed aren’t far behind.

New poll to your right or here: Have you ever donated money to a hospital or health system without being pressured and without expecting a personal benefit? Those of us with health system management experience know that feeling of dread when the calendar invitation arrives for the upbeat meeting in which we will be collectively pressured to donate to hospital projects or to the United Way, with the clear but carefully unstated hint that our strong-armed magnanimity could affect the “team player” portion of our performance reviews. I would rather flush money down the toilet literally than to give it to hospitals to flush figuratively, but that’s just jaded and cynical me.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

We provided STEM activity kits for Ms. P’s elementary school class in Florida in funding her DonorsChoose teacher grant request. She convenes STEM creation periods 2-3 times per week in which the students choose which materials they want to use, concluding, “The creativity and collaboration going on at this time is priceless. I also love watching how they take each other’s ideas into consideration and work together to make the best end result possible.”

This Week in Health IT History

One year ago:

• An MD Anderson Cancer Center internal report warns that the organization will lose $450 million in FY17, with the cost of its Epic implementation named as one of the four contributing factors.
• McKesson lays off 60 employees of its Enterprise Information Solutions business.
• Walgreens files a $140 million lawsuit against former partner Theranos.
• Siemens announces that it will take its Healthineers division public.

Five years ago:

• Hearst acquires Milliman Care Guidelines.
• Kaiser Permanente promotes President and COO Bernard Tyson to chairman and CEO, replacing George Halvorson.
• Allscripts CEO Glen Tullman confirms reports that the company is seeking strategic alternatives.

Ten years ago:

• CCHIT announces the first six inpatient EHRs to earn its permanent or conditional certification: CPSI, Eclipsys, Epic, HMS, Prognosis Health, and Siemens Soarian.
• A House bill supports independent health record trusts.
• Cerner says KU hospital let Kansas City down by choosing Epic, leading the hospital CIO to counter that it was happy to pay more for Epic than Cerner because its doctors like it a lot better.
• Cerner wins a nine-year contract to install PathNet in the VA.

Last Week’s Most Interesting News

• Allscripts turns in decent quarterly results.
• Documents filed with the state of Georgia indicate that Athenahealth will close its Atlanta support center and lay off 61 employees the week before Christmas.
• Meditech announces a big quarterly product revenue jump even as earnings slid 31 percent.
• Cerner blames its quarterly revenue and earnings expectation shortfall on big deals that didn’t close and less-than-expected performance from its IT outsourcing business.

Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

From the Allscripts earnings call:

• The company says it is approaching $2 billion in annual revenue, making it the second-largest publicly traded pure health IT vendor.
• Allscripts will continue to support the former McKesson Star and HealthQuest revenue cycle solutions.
• The company confirmed that it cut headcount among the former McKesson employees almost immediately after the acquisition and did the same within the Allscripts group in Q3. It also shut down an Allscripts office in Atlanta in consolidating employees into the former McKesson office in Alpharetta.
• Allscripts plans to quickly integrate the former McKesson EIS into its operations, eliminating its separate identity within two quarters.
• The move of Horizon Clinicals into discontinued operations will be complete by Q1 of next year. As McKesson had previously announced, Horizon support will end in March 2018, although the company suggests that outside companies may provide some level of customer support.
• The company says it has not yet obtained customer feedback on McKesson’s laboratory information system but is interested in doing that.
• Allscripts plans to GA its new, cloud-based ambulatory EHR next year, touting its strengths as usability, interoperability, mobility, and inclusion of embedded AI tools.

Politico reports that Patrick Soon-Shiong publicly bragged to investors about sales of NantHealth’s GPS Cancer genetic test to hospitals without telling them that some of the ordering doctors are or were on his payroll as consultants.

People

Medical second opinion vendor More Health hires Jeffrey Lasker, MD, MMM (Vision Healthcare Consulting) as chief physician officer.

Heather Haugen, PhD, MS (Xerox) joins Atos as chief science officer.

Press Ganey hires Jason Erdell (Change Healthcare) as president and chief client officer.

Announcements and Implementations

Southeastern Health (NC) will go live on Epic this month under its shared services agreement with Carolinas HealthCare.

Government and Politics

A former compliance team member of Epic customer WakeMed (NC) files a whistleblower False Claims Act lawsuit claiming that Epic defaults its software to bill both anesthesia base units and procure time in surgical cases, resulting in double billing that totals hundreds of millions of dollars across all Epic clients. Epic says the whistle-blower apparently doesn’t understand how claims software works and notes that the Department of Justice has already declined to get involved.

Four members of Congress who serve on the House Committee on Veterans Affairs introduce legislation that would compel VA Secretary David Shulkin to provide the committee with documents covering timelines and costs of its planned Cerner implementation.

New FDA guidance tells medical device vendors that it’s OK to share the information that those devices collect directly with the patients using them with seeking additional FDA marketing approval, as long as those manufacturers provide no further interpretation than they already offer to physicians. FDA also acknowledges that some devices don’t collect information in a patient-friendly or shareable format and suggests that manufacturers tell patients to contact their doctors with any questions.  

Other

Craig Joseph, MD notes the awkward signage required to tout Epic as an AMIA 2017 sponsor despite the absence of a company Twitter account.

Drug overdose deaths jumped 21 percent last year, a bigger increase than that of the previous four years combined. Gun-related deaths also took a turn upward from 9,600 to 11,000, with two-thirds of the total involving suicide. The biggest killers – cancer and heart disease – are on the decline, although drugs and guns more than offset those as the death rate actually increased.

An apparently intoxicated cardiologist in Russia takes sick leave after being captured on video rambling incoherently and trying unsuccessfully to enter his computer password.

Sponsor Updates

• QuadraMed, a Harris Healthcare company, will exhibit at HealthAchieve November 6-7 in Toronto.
• Salesforce will host its annual Dreamforce conference November 6-9 in San Francisco.
• Surescripts will exhibit at the 2017 NextGen One User Group Meeting November 5-9 in Las Vegas.
• Huron will exhibit at Salesforce’s Dreamforce event November 6-9 in San Francisco.

Blog Posts

• The Wisdom of AI in Breast Cancer Research (Salesforce)
• Do Payers Use Utilization Management to Their Advantage to Deny Claims? (The SSI Group)
• Boost Patient Engagement with These 5 Easy Holiday Campaigns (Solutionreach)
• Journey of a Woman in STEMM (Sphere3 Consulting)
• Technology, clinical power, and a unified health plan deliver better results, together (Verscend Technologies)
• Frankenphone still lives! (Voalte)
• Seven Elements of Effective Clinical Communication (Vocera)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 11/3/17

Top News

Allscripts announces Q3 results: revenue up 15 percent, adjusted EPS $0.16 vs. $0.14, beating revenue expectations and meeting on earnings. Share price was unchanged in early after-hours trading.

The company raised its 2017 financial outlook. It also reiterated its expectation to spend $50 million in severance and transaction costs starting in Q4 related to its acquisition of McKesson’s Enterprise Information Solutions business.

Reader Comments

From Desperado: “Re: Verity Health (fka Daughters of Charity). As expected and reported on HIStalk, they are implementing Allscripts enterprise-wide. It will be interesting to see how the organization uses consultants, as the new owner Patrick Soon-Shiong is already rapidly cutting consultants.” Unverified. It was obvious that Verity was the client when Allscripts announced a new six-hospital Sunrise sale in August without naming its customer. Verity is rumored to have scrapped a year’s worth of product evaluations in being forced to choose non-frontrunner Allscripts as part of a deal between Soon-Shiong and Allscripts, which lost $150 million from buying since-devalued NantHealth shares as Soon-Shiong took a $100 million position in Allscripts stock that also went down. I’m sure Allscripts is happy to get a new Sunrise sale and the chance to earn back some of the losses that resulted from its ill-advised dealings with Soon-Shiong, but shotgun implementations by financially struggling health systems don’t always go well.

From Who Is Infoblocking: “Re: Sutter Health’s patient portal. Apparently early adopters of Epic’s portal have taken a big step backward when it comes to the ability of patients to download their health records, making it unreasonable for providers to attest unless the problem is addressed. See the attached error message, which appears nine times out of 10 when trying to download visit summaries. Not clear if this is a generic Epic issue or specific to the Sutter implementation.” Unverified, but odd if it sometimes works and sometimes doesn’t.

From This One Goes To 11: “Re: Athenahealth. Seems worried about a takeover of the company based on a recently filed 8-K.” Athenahealth’s October 23 change-in-control filing protects its top executives from acquisition-related termination by guaranteeing them a one-year severance, a 100 percent expected bonus payout, 12 to 18 months of continued medical and dental coverage based on position, immediately vested stock options, and a $10,000 outplacement grant.

From Albacore: “Re: Athenahealth. I’m surprised by its layoffs in Atlanta, which includes closure of its entire client service center, 61 jobs in total. Affected job titles as reported to the state are a far cry from sales and marketing. RazorInsights was headquartered near Atlanta. Wonder how many of these people are supporting the inpatient platform and if this is early recognition of Athena pulling back from the inpatient market?” Unverified. Scheduling a layoff to start one week before Christmas is pretty cold. 

HIStalk Announcements and Requests

I mentioned the excellent book “Misbehaving: The Making of Behavioral Economics” by newly minted Nobel winner Richard Thaler. Here’s an example of a brilliant observation from it. The CEOs of companies nearly universally seek high-risk but potentially high-reward startup acquisition deals, knowing that while most of the companies will fail, one or two will hit a home run and make the process profitable (the same theory venture capitalists apply). However, the decisions of which acquisitions to pursue rests in the hands of VPs, whose perception is that their personal upside to a successful acquisition is minimal (maybe a small bonus or promotion), while their downside risk is getting fired for choosing an unsuccessful one. That means CEOs will never know about deals that would interest them and potentially be in the best interest of the company and its shareholders. Thaler suggests that a single VP be held responsible for the overall performance of a package of acquisitions instead of being personally tied to just one. It is fascinating to me how corporate strategies and execution can be derailed by people whose biggest fear is being fired and who act accordingly. I’ve seen some ugly internal fights even in non-profit health systems, where mid-level executives destructively wage guerilla warfare against each other in trying to increase their influence or future job prospects. Patients were incidental to the infighting, of course. Organizational Behavior was one of my favorite MBA courses.

This week on HIStalk Practice: CMS Administrator Seema Verma announces “Meaningful Measures” effort. Performance Solutions launches orthopedic practice transformation service. Health2047 invests $12 million in new business. AMA President David Barbe, MD shares frustrations with his home state’s lack of a PDMP. Heal expedites house-call access to lactation consultants, PTs. Teladoc creates new executive role, reports on Q3. The Missouri State Medical Association works on members-only HIE. Impact Healthcare implements opioid addiction treatment app.

Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Arrhythmia diagnosis technology vendor IRhythm Technologies reports Q3 results: revenue up 49 percent, EPS –$0.28 vs. –$2.80, beating analyst expectations for both and raising revenue guidance. Shares are up 117 percent in the past year, valuing the company at just over $1 billion.

LabCorp makes an unspecified equity investment in MC10, which offers wearable sensors for clinical trials participants. The company had previously raised $72 million.

Leidos announces Q3 results: revenue up 34 percent, adjusted EPS $0.95 vs. $1.25, beating earnings expectations but falling short on revenue.

Philips predicts that its health technology focus will increase sales 4-6 percent in the next three years.

Apple reports Q4 results: revenue up 12 percent, adjusted EPS $2.07 vs. $1.67, beating analyst expectations for both with strong contributions from the iPhone 8 and 8 Plus. Shares rose nearly 5 percent in early after-hours trading as Apple closes in on becoming the first $1 trillion market cap company.

Sales

In Thailand, Bangpakok 9 International Hospital chooses Medicomp’s Quippe Basic for point-of-care electronic documentation. 

Cayuga Medical Center (NY) chooses Summit Healthcare’s Exchange platform to exchange CCDs, taking advantage of an integrated HISP, API extendibility, and a customization mapper to support future standards-based integration initiatives. 

Two former CPSI community hospital customers return in choosing Evident’s Thrive EHR – Seiling Municipal Hospital (OK) and El Campo Memorial Hospital (TX). Both hospitals have new operators who reversed previous decisions to move to the systems of unnamed CPSI competitors. Ironically, Athenahealth showcased Seiling in a splashy announcement just two weeks ago, with the hospital’s CEO bragging on how its system helped with the its financial turnaround and criticizing “our previous vendor” that has apparently shed the “previous” part of the title under a new management company.

In Australia, the Chris O’Brien Lifehouse cancer hospital will implement Meditech 6.x modules for oncology, pharmacy, materials management, and patient portal.

Edward-Elmhurst Health (IL) selects Outcome Health’s waiting room advertising system.

People

Clinical documentation system vendor ChartWise Medical Systems names Steven Mason (MedeAnalytics) as president and COO.

Oncology benefits management company Oncology Analytics hires Rick Dean (UnitedHealth Group) as CEO and board member. He replaces founder Marc Fishman, who will serve as executive chairman.

Announcements and Implementations

Clinical Computer Systems, Inc. completes integration of its Obix Perinatal Data System with Medhost at Cibola General Hospital (NM).

Healthwise launches shared decision-making programs orthopedics, cardiology, urology, primary care, and end-of-life, with the patient-expressed preferences saved back to the the patient record via HL7 connectivity.

Prescription affordability and adherence solutions vendor ConnectiveRx announces that it has worked with analytics vendor EagleForce Health to screen 12 million prescriptions in support of the federal anti-kickback statute, in which government health plan prescriptions are reviewed in real time to make sure that no pharma co-pay cards or patient savings cards are used.

Washington, DC rolls out PulsePoint Respond, a free phone app that 911 operators can use to notify CPR-trained users of nearby cardiac arrests. The app also displays the location of nearby automatic external defibrillators.

Google’s AI-focused startup incubator announces four companies for its first class, all of them working in health IT. The chosen startups get training, mentorship, equity-free support, and access to hardware and software.

• Augmedix (Google Glass-power remote scribing)
• BrainQ (brain wave analysis following neurological disorders)
• Byteflies (wearable vital sign monitoring)
• Cytovale (ED sepsis detection)

University of Miami Health System (FL) goes live on Epic and renames its hospital-based facilities to University of Miami Hospital and Clinics as it transitions to an academic teaching hospital. 

Government and Politics

The AHA and two other hospital lobbying groups sue CMS in trying to stop reduction in payments under the 340B Medicaid drug rebate program that was originally intended to help underfinanced hospitals procure drugs for indigent patients. Hospitals make a small fortune (and have raised pharma’s ire) since the law doesn’t require them to limit the use of discounted drugs use to indigent patients or to pass along their savings to consumers or insurers, directly boosting their bottom lines but reducing those of drug manufacturers. An earlier analysis found that a single oncologist could boost a hospital’s profits by $1 million in ordering the discounted chemo drugs for patients with commercial insurance.

Innovation and Research

A “liquid biopsy” blood test detects changes in a patient’s BRCA1 or BRCA2 breast cancer genes that require switching chemotherapy drugs, an application of precision medicine that allows tailoring drug therapy as tumors become resistant.

A study finds that the symptoms and exertion tolerance of non-emergency chest pain patients don’t improve after having a cardiac stent implanted. The study surprisingly involved performing phony stent implants on half the study patients, then compared the outcomes to those who received real stents. It will be interesting to see how this affects the hundreds of thousands of stents implanted each year, given that: (a) providers get paid richly for installing stents; (b) patients are always looking for a quick solution to their problems and have grown used to the idea that stents are a cure-all; and (c) doctors will likely be reluctant to reduce their stent use for fear of being sued for malpractice.

Other

The local paper profiles an Oregon-based union employee of Legacy Health who says her hospital-provided health insurance –issued by an insurer acquired by the health system for a reported $247 million — “hardly covers anything” in her lymphoma care. The paper notes that the hospital is taking the employee to collections even as it booked a $126 million profit last year and paid its CEO $2.3 million.

A McKinsey report on digitization of the banking industry likely has healthcare implications. New digital competitors like Amazon, Alibaba, and Google are threatening the bottom lines of banks, but those banks that embrace technology and improve their marketing and analytics will reap huge profits through upselling, optimizing their branch formats, enhancing sales productivity through tablet-based digital tools, industrializing operations with automation and artificial intelligence, and adopting APIs to allow working around legacy systems. McKinsey coins the “four horsemen of the e-pocalypse” to describe threats from digital players:

• Disintermediation, as customers move to other technologies to borrow money, send money, or buy low-cost goods without using a debit card.
• Unbundling, where non-bank companies like PayPal cherry pick profitable banking services that leave banks running money-losing services such as checking accounts.
• Commoditization, where undifferentiated banks fail to create brand loyalty.
• Invisibility, where customers can buy unbranded services without knowing or caring which bank provides them, with banks suffering from a loss in the customer relationship.

Alex Wubbels — the Salt Lake City hospital nurse who was manhandled by a since-fired city detective for following hospital policy in refusing to allow blood to be drawn from an unconscious patient — will receive a $500,000 payment even though she didn’t file a lawsuit. Salt Lake City and the University of Utah will each pay $250,000. Wubbels says she will use part of the money to help people obtain police body camera footage to prove their claims. She will also donate to the Utah Nurses Association and lead the ANA’s #EndNurseAbuse campaign.

Sponsor Updates

• LogicStream Health employees pack food boxes for The Food Group.
• Medicomp Systems showcases the capabilities of its Quippe Clinical Data Engine on its updated website.
• Netsmart will work with nursing facility operator Cantex Continuing Care Network to develop a smart referral management solution.
• LifeImage joins Google Cloud as a technology partner.
• Imprivata is named Cerner’s 2017 Partner of the Year.
• Two Meditech-using hospitals in Maryland earn HIMSS EMRAM Stage 7.
• Sonifi Health will offer evidence-based health education from Healthwise to customers of its interactive patient engagement system.
• EClinicalWorks will exhibit at the National Conference on Correctional Health Care November 4-8 in Chicago.
• FormFast, Healthwise, and Kyruus will exhibit at Salesforce’s Dreamforce conference November 6-9 in San Francisco.
• Imprivata will exhibit at HealthAchieve November 6-9 in Toronto.
• Intelligent Medical Objects Chairman, Founder, and CEO Frank Naeymi-Rad receives AMIA’s Leadership Award.
• Healthcare Growth Partners advises Ascend Learning in its acquisition of health simulation vendor Kognito.
• Liaison Technologies embeds cloud-friendly ECS integration capabilities into its Alloy Edge solution.
• MedData and Experian Health will exhibit at the HFMA Region 9 Annual Conference November 5-7 in New Orleans.
• Medecision customer Christiana Care Health System earns the John M. Eisenberg Patient Safety and Quality Award.
• Navicure will exhibit at the NextGen One Conference November 5-8 in Las Vegas.
• Netsmart will exhibit at the American Public Health Association Annual Meeting & Expo November 4 in Atlanta.
• NTT Data Services will present and exhibit at Salesforce’s Dreamforce conference November 6-8 in San Diego.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the NOHIMSS Fall Conference November 10 in Cleveland.
• PatientKeeper will exhibit at HealthAchieve November 6-7 in Toronto.

Blog Posts

• ERPs are Important Too (Optimum Healthcare IT)
• What’s That Noise!?: How Technology Can Help Create a Quieter Hospital (Spok)
• 5 Technologies Patients Actually Use (Redox)
• Three Tips to Boost Popularity in Population Health (Leidos)
• How to identify an excellent project manager (Nordic)
• The Importance of Knowledge Transfer: 5 Tips to Consider Now (Hayes Management Consulting)
• Continuous Availability of Clinical Applications (The HCI Group)
• Revenue Integrity – Not Just for the Billing Folks! (Impact Advisors)
• Why EPCS Matters: Protecting Against DEA Number Theft (Imprivata)
• Reputation Beyond the HCAHPS Scores (Influence Health)
• Healthcare Payments Myths (InstaMed)
• Intrinsic and Extrinsic Physician Motivators to Consider When Driving Change (Kyruus)
• How Long is Lab Access for a Course Available? (Learn on Demand Systems)
• 5 Ways Nurses Can Drive Patient Safety (Meditech)
• Why Data Quality Makes or Breaks Population Health Efforts (Lightbeam Health Solutions)
• 4 Ways to Migrate From VMware to AWS Cloud (LogicWorks)
• Clinical Conundrum: Too much data, not enough meaning (Medicomp Systems)
• ONC Interoperability Pledge (Netsmart)
• Avoid fines and penalties: Make sure your debt collection agencies are compliant (Experian Health)
• PatientTouch Happily Haunts the Halls of Parkview Medical Center (PatientSafe Solutions)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 11/1/17

Top News

CMS clarifies the information blocking requirement of MIPS for providers. Eligible providers must attest that they:

• Haven’t disabled the interoperability capabilities of their EHR.
• Have implemented their EHR without taking any actions to limit interoperability.
• Quickly respond to requests from patients and other providers who ask for information retrieval or exchange.

CMS advises that no documentation is required to be submitted as part of the attestation. It also notes that while attesting providers aren’t expected to understand or enable the technical side of interoperability, it’s their job to let their implementers and EHR vendors know that they will be attesting and hold them accountable for enabling that capability.

Reader Comments

From Good-Time Charlie: “Re: Practice Fusion. I didn’t remember until your poll that they were even still around.” They are, but seemingly barely, well out of contention as an ambulatory EHR disruptor despite having raised $200 million from investors under that premise. ONC places Practice Fusion as the #9 most commonly used ambulatory EHR based on attestation data, which isn’t so good given that their product is free (and the products that follow them on ONC’s list aren’t really major-name EHR vendors). The company seemed unstoppable when doctors flocked to its product to collect $44,000 in Meaningful Use money in return for spending nothing, but the company’s business model was questionable, they were selling practice data in less-than-transparent ways (such as not naming who was buying it and for what purpose), its self-reported usage figures were head-scratching at times, and there was always the question of just how deeply practices engaged with the product since they had no skin in the game (no hardware cost, contract, training cost, etc.) The company fired founder and CEO Ryan Howard in mid-2015 right before a planned IPO, promoted a replacement with skimpy credentials for taking a company public, and largely fell off everyone’s radar.

From Dinky McQueen: “Re: GE’s rumored discussion about selling its healthcare IT business. Is it everything from Centricity on down, or just smaller, unaligned divisions such as the GE-Intel Care Innovations JV?” I haven’t heard specifics but would be interested. The health IT business includes the many products labeled as Centricity, workforce management (the old API Healthcare), Health Cloud, diagnostic-related software, and some analytics stuff. It’s hard sometimes to figure out where healthcare IT begins given the overlap with the company’s diagnostic business, which I assume won’t be dealt off. GE has built a poorly managed, unfocused portfolio of acquisitions that will be hard to sell off to a single buyer, which will probably elongate any process to make its unlamented healthcare IT exit.

From Just Saying: “Re: speech recognition. You mentioned years ago using speech recognition to write HIStalk. Do you still do that?” I don’t. Three or so times I bought the latest version of Dragon and got excited about how much easier it was to “write” HIStalk by talking instead of typing, but the sheen wore off due to Dragon’s heavy system usage, occasional mysterious errors that lost what I had dictated, and the time required for me to fix its mistakes (nearly always caused by my not articulating crisply enough). I’m thinking about trying again with LilySpeech, a cloud-based system that uses Google’s speech-to-text system. I don’t need voice-controlled system automation – I just want to dictate into a text box and paste the result into my editor or Gmail. I’ll give the 30-day free trial a shot.

HIStalk Announcements and Requests

I enjoyed reading a recent interview with freshly named economics Nobel winner Richard Thaler and was therefore happy to see his “Misbehaving: The Making of Behavioral Economics” pop up as a free Prime Reading Kindle book this week. I was engrossed and entertained by it, to the point that I ordered a softcover version (at full price) just so keep it handy and to be able to lend it out. This book and his earlier “Nudge” explain why humans don’t always follow rational economic thought, which of course has healthcare implications along with big-time business impact. I highly recommended the first book and will no doubt do the same for the second once I’ve read it. He’s a great explainer and pretty funny besides.

The only iOS device I have left is my iPad Mini, but even that is now a little closer to Android – I replaced the default iOS mail app with Gmail and like it much better, especially for deleting endless streams of spam without having to swipe emails individually and trying to recall the difference between “archive” and “move to trash.”

Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Meditech announces Q3 results: revenue up 9.8 percent, EPS $0.47 vs. $0.68. Product revenue jumped 50 percent, but a slight drop in services revenue and an 18 percent increase in operating expense drove earnings down 31 percent.

Roper Techologies (Sunquest, Strata Decision Technology, Atlas Medical, Data Innovations, CliniSys) announces Q3 results: revenue up 23 percent, adjusted EPS $2.36 vs. $1.96, meeting revenue expectations and beating on earnings.

Germany-based Ada Health, which offers consumers an AI-powered health chat app that also connects users to doctors, raises $47 million and announces plans to open a US office.

Sales

Hospital for Special Surgery (NY) will expand its use of Docent Health to provide customized, whole-person support that addresses each patient’s needs, fears, and concerns.

Orlando Health chooses Phynd to manage the information of 25,000 providers across nine hospitals.

People

Geoff Hogan (Imprivata) joins Diameter Health as chief commercial officer.

Impact Advisors promotes VPs Paula Elliott and Bill Faust to leadership roles over its quality services and strategic implementation services practices, respectively.

Announcements and Implementations

Casenet’s TruCare is named Best Population Health Management Software Provider in a UK healthcare and pharmaceutical awards program.

HIMSS announces that Alphabet Executive Chairman Eric Schmidt will deliver the opening keynote at HIMSS18 in the “still seems weird” time slot of Monday, March 5 at 5:00 p.m. PT. Schmidt provided the very long keynote at HIMSS08 in Orlando, where he pitched since-failed Google offerings like Health and Flu Trends. 

Government and Politics

Politico reports that HHS privacy leader Deven McGraw, JD has left government service to join an unnamed Silicon Valley health technology startup.

Publicly traded, Cincinnati-based Chemed, which owns the country’s largest for-profit hospice chain, will pay $75 million to settle False Claims Act charges that it billed Medicare for services involving patients who were not terminally ill and paid its employees bonuses for recruiting new patients. Three whistleblowers will share in the payout. Trivia: Chemed’s other big holding is Roto-Rooter. 

Other

Vanderbilt University Medical Center (TN) will go live on Epic this week.

The April 1 Cerner go-live at Medical Center Health System (TX) led to billing delays that left it behind for the fiscal year ending September 30. A consultant’s report says that hospital executives blamed staff for lack of commitment and not paying attention during training, but most employees said that training was insufficient for doing their jobs. 

A study finds that 10 percent of Massachusetts residents who were revived from opioid overdoses with rescue drug Narcan died within a year, highlighting that only five percent of overdose survivors receive longer-term treatment drugs such as Suboxone.

Brilliant: a company in Japan gives non-smokers an extra six days of vacation, both as an incentive for smokers to quit and to give non-smokers the same amount of non-productive time enjoyed by smokers.

Weird News Andy helpfully notes that maybe the patient should have considered flossing. Doctors examining a woman with a decades-long history of nosebleeds believed to be caused by rhinitis finally determine the cause – a fully grown tooth embedded in her nasal cavity. Dentists say “supernumerary teeth” can grow in odd spots on the face in the 4 percent of people affected, but having them erupt in the nasal cavity is extremely rare. 

Sponsor Updates

• Meditech, which has 20 customer sites in Puerto Rico, donates money to United for Puerto Rico.
• AdvancedMD will exhibit at APTA’s Private Practice Section event November 1-4 in Chicago.
• HIS 2017 recognizes Agfa Healthcare in the IT Industry category – RIS and PACs during its annual awards ceremony.
• AssessURHealth publishes a new white paper, “The Missing Piece: Holistic Care through Preventive Screenings.”
• Bernoulli Health will exhibit at HealthAchieve November 6-7 in Toronto.
• Besler Consulting will present at the Minnesota HFMA Regulatory Conference November 2 in Bloomington.
• CSI Healthcare IT completes the first wave of Epic go-lives at Lovelace Health System (NM).
• Clinical Architecture will exhibit at the AMIA 2017 Annual Symposium November 4-8 in Washington, DC.
• CoverMyMeds, CTG, and Cumberland Consulting Group will exhibit at the CHIME Fall CIO Forum October 31-November 2.

Blog Posts

• Revenue Integrity – Not Just for the Billing Folks! (Impact Advisors)
• Peninsula Regional Medical Center Improves Patient Care Coordination With Spok (Spok)
• Powered by Passion: MEDITECH, Physicians, and CIOs Connect Over Personal Health Stories at Annual Physician and CIO Forum (Meditech)
• Using Technology to Build an Integrated Practice #3 of 6 (AdvancedMD)
• Do you have $360k to build compliance into your digital health product yourself? (Datica)
• Finally Following the Patient Journey (CarePort)
• How Population Health Can Move Beyond Analytics to Achieve Wider Benefits (Casenet)
• The Secret to Gaining Staff Buy-In for RTLS (CenTrak)
• Voice Dictation Enables Physicians to Recover Lost Hours from a Packed Workday (ChartLogic)
• Decentralized vs. Centralized Access at Health Systems: The Patient’s Perspective (Culbert Healthcare Solutions)
• 3 Ways Measure Factory will Enable Data-Driven Decision Making (Dimensional Insight)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 10/30/17

Top News

From the Cerner earnings call following announcement of Q3 results that fell short of expectations for both revenue and earnings:

• The company blames its bookings shortfall on “several large deals that were forecast for the quarter that did not come through,” with ITWorks complete outsourcing providing deals being a big contributor to the shortfall.
• Cerner notes that the lack of Meaningful Use-driven customer urgency is making it harder to create reliable sales forecasts.
• The company says it is seeing success against Epic as customers focus on return on investment and notes that new hospital EHR entrants “have over-promised and under-delivered.”
• The company expects to sign its contract with the VA by the end of the year, in which Cerner will function as the prime contractor with subcontractor partners to be announced later.
• President Zane Burke expects that the VA contract terms will involve a series of task orders that will provide percentage-of-completion payments over several years.

Cerner shares dropped 8.43 percent Friday after the earnings report.

Above is the five-year share price of CERN (dark blue, up 68 percent) vs. the Nasdaq (light blue, up 125 percent).

Reader Comments

From Snowman: “Re: Citrix. Hearing 40 percent increases in maintenance fees when renewing. That’s another $300,000 per year for our medium-sized facility. Does that make them a monopoly?” Unverified. Anyone else seeing big maintenance jumps? Citrix isn’t exactly a monopoly since alternative virtual desktops exist, but its product is deeply embedded into the infrastructure and software vendor contracts of most hospital IT shops. I would be interested to hear from hospital CIOs who switched successfully from Citrix to something else for their core healthcare-specific apps and whether they experienced support issues.

From IT Maven: “Re: University of Washington. UW Medicine has had three chief health system officers in less than a year. Does this have anything to do with their decision no to go with Epic?” I doubt Epic was a key consideration for an executive of that level. The new CHSO’s predecessor lasted less than a year before stepping down in a mutual decision, replaced by an interim that I assume the reader is counting as the third person to hold the job since November 2016.

From Master of Startup Puppets: “Re: Crunchbase series. I think HIStalk readers would enjoy it.” The series called “A Startup Takes Flight” is an interesting fictional case study that covers early-stage funding, venture capital deal terms, and what happens when a startup sells.

From Not A Client: “Re: Medi-Span data. Has been removed from RxNorm at the request of Wolters Kluwer. Not sure if this is newsworthy since I’ve seen nothing outside the NLM site.” The October 2 RxNorm release notes verify that Medi-Span data was removed from RxNorm at the company’s request. NLM has just announced that the September 2017 RxNorm release expanded the Medi-Span data set.

From The PACS Designer: “Re: LiFi Mobile. LEDs can act as transmitters of signal in wireless systems. LiFi is high speed, bi-directional networked and mobile communication of data using light. LiFi comprises of multiple light bulbs that form a wireless network, offering a substantially similar user experience to Wi-Fi except using the light spectrum.” It sounds interesting, but line-of-sight requirements, as well as possible interference from ambient light, would seem to limit usefulness.

HIStalk Announcements and Requests

Poll respondents are mostly skeptical that IBM Watson will make a healthcare splash.

New poll to your right or here: which ambulatory EHR vendor has fallen hardest from HIT front-runner status? I recognize that Allscripts and GE Healthcare aren’t just ambulatory EHR vendors, but their presence there earns them a poll spot.

For those with short memories or short healthcare IT careers, it’s time to relearn the oft-repeated lesson that big companies dip their toes into and out of the healthcare IT waters all the time with little loyalty to anyone except shareholders. McKesson bailed out this year and now GE  is apparently mulling its exit after wrecking a slew of acquisitions over many years. Siemens is long gone. Nothing good ever comes from conglomerates licking their chops at what they naively think is easy money and higher growth than their other verticals (see also: Misys and Sage). How hard could this healthcare thing be?

This Week in Health IT History

One year ago:

• A poor McKesson earnings report sends shares down 23 percent, while competitors Allscripts and Cerner also post lackluster earnings.
• A Politico article says that Epic and EClinicalWorks are impeding data-sharing with public and specialty registries.
• CMS approves continuous 90-day reporting period for its EHR Incentive Program and eliminates specific objectives and measures.

Five years ago:

• McKesson talks up its MedVentive and MED3OOO acquisitions in its earnings call, hints that the company might work with Athenahealth following its acquisition of PSS World Medical, and admits that some Horizon customers are passing on the chance to migrate to Paragon.
• A Wells Fargo Securities analysis finds that the lowest-percentage hospital EHR attestation vendors are GE Healthcare, QuadraMed, NextGen, and McKesson.
• CHIME President and CEO Rich Correll announces plans to move to a COO role.
• SCI Solutions founder John Holton retires from the company.
• Humana acquires Certify Data Systems.

Ten years ago:

• CSC acquires First Consulting Group.
• Perot Systems conducts massive layoffs.
• ZDNet declares MIsys to be an open source health IT competitor to Medsphere.
• ONC funds a significant grant to have definitions developed for the terms EHR, EMR, PHR, HIE, and RHIO.
• Virtua Healthcare (NJ) says its $500 million, 368-bed new medical campus will use technology to transform healthcare.
• Philips announces plans to sell its 70 percent stake in MedQuist. 

Last Week’s Most Interesting News

• Cerner falls short of Wall Street expectations for both revenue and earnings in its quarterly report, sending shares down hard.
• CVS is rumored to be in talks to acquire Aetna.
• GE explores selling its healthcare IT business.
• A second former executive of Cleveland Clinic Innovations is arrested for fraud involving spinoff Interactive Visual Health Records.

Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Quality Systems (NextGen) announces Q2 results: revenue up 4 percent, adjusted EPS $0.22 vs. $0.23, beating analyst expectations for both. From the earnings call:

• The company says it was hit by turnover in its sales team as “a number of legacy sales resources and managers elected to move on,” with the resulting loss of client relationships hurting the close rate for larger deals. The company confirmed that 13 of 70 salespeople have left and have been replaced.
• The company is still trying to salvage one unnamed large client that has threatened to defect.
• NextGen is emulating Athenahealth in offering pricing based on a percentage of net collections.

Above is the five-year share price of QSII (dark blue, down 19 percent) vs. the Nasdaq (light blue, up 125 percent).

Tenet Health will lay off 1,300 employees.

A Healthcare Growth Partners report finds that health IT investment is continuing at a record pace even as M&A activity has stagnated. The quarter’s big M&A deals were the merger of Navicure and ZirMed, the sale of The Advisory Board Company’s healthcare business to Optum Health, and the sale of WebMD. The big investment theme was genomic medicine. The article notes that the industry must be assuming that total addressable market and M&A activity will increase to absorb the 46 percent annual growth rate in investment that has occurred since 2011.

Sales

Everest Rehabilitation Hospitals (TX) chooses Medhost for two hospitals to be constructed.

People

Aviacode CEO Keith Hagen takes on the additional role of board chair.

Announcements and Implementations

Medecision launches 10 care management apps for care, utilization, and disease management; network management; and care coordination.

T-System says 70 percent of its new contracts involve its hosted solutions for episode-based care, which includes hospital EDs, freestanding EDs, and urgent care centers.

Definitive Healthcare adds retail health clinics and assisted living facilities to its healthcare provider database.

Akili Interactive, Propeller Health, Voluntis, and WellDoc launch the Digital Therapeutics Alliance to support clinically validated solutions.  

Privacy and Security

Drug maker Merck says it lost $135 million in Q3 sales and spent $175 million in direct cost due to its Petya ransomware attack in June. The company said in the earnings call that its Q4 results will be similarly impacted, raising the cost of its ransomware attack to at least $620 million.

Other

A vascular surgeon testing the FDA-cleared Butterfly IQ ultrasound device for smartphones decides to scan his sore throat, the result of which reveals that he has a since-treated cancerous mass.

Microsoft ends production of its Kinect 3-D mapping and body movement sensor that in addition to is main purpose as an Xbox game controller was used in some healthcare applications, such as those for physical therapy, rehab, and health screening. Part of Kinect’s technology has been rolled into Microsoft’s Hololens.

Medical device executive David Mortara, PhD donates $25 million to the UCSF School of Nursing to fund a center that will study alarm fatigue and overly sensitive ECG machines that contribute to it. Mortara sold his diagnostic cardiology and patient monitoring device company to Hill-Rom for $330 million in cash in January 2017.

Actress and investor Eva Longoria helps introduce a virtual visit kiosk that will be offered to residents of an affordable workforce housing community in Texas.

An interesting article looks at the big business of scrubs, worn every day by the nearly one in five Americans employed in healthcare who generate $10 billion in annual sales, mostly to wearers who buy their own. The latest innovation beyond adding licensed cartoon characters and form-flattering designs: scrubs impregnated with antimicrobials to help reduce the spread of infection.

In Scotland, the Royal Pharmaceutical Society says community pharmacists don’t have access to the electronic medical records of patients as they were promised, requiring them to call an NHS hotline to obtain the information they need.

Thomas Health (WV) lays off 10 IT employees following consolidation of systems it didn’t name. The hospital announced plans last year to move from Cerner/Siemens Soarian and Meditech Magic to Meditech 6.1.

Weird News Andy is weirded out by this story covering the largely unregulated “tissue banks” that offer free cremation – sometimes in cahoots with funeral homes who invest in the companies — in return for donating organs to “advance medical studies.” It calls out Southern Nevada Donor Services, whose employee was caught using a garden hose in the parking lot of its warehouse to thaw a human torso, sending tissue and blood into a gutter. Most of the known “body brokers” are for-profit companies, one of which earned $12.5 million in three years. The companies were launched for as little as the $100,000 needed to buy a van and freezers, with some of the more frugal ones using a chainsaw instead of the much more expensive surgical saw to disassemble their donors into marketable components.

Vince takes us back to November 1987, when pre-adult Tiffany (who is now 46 years old) ruled the pop charts with “I Think We’re Alone Now” and a surprising health IT vendor’s ad bragged on being backed by a $5 billion company (which, like most big companies dabbling in healthcare, didn’t stick around long).

Sponsor Updates

• Forward Health Group founder and CEO Michael Barbouche is named to Madison Magazine’s M List of health innovation leaders and will speak at a reception and dinner on November 9.
• ZappRx will attend the CHEST conference October 28 – November 1 in Toronto and the North American Cystic Fibrosis Conference November 2-4 in Indianapolis. The company will also exhibit at the PFF Summit November 9-11 in Nashville.
• Aprima will exhibit at the American College of Phlebology’s 2017 Annual Congress November 2-5 in Austin, TX.
• Surescripts will exhibit at the Digital Quality Summit November 1-3 in Washington, DC.
• T-System sees swelling demand for its hosted healthcare solutions.
• TriNetX will exhibit at the AMIA Annual Symposium November 4-8 in Washington, DC.
• Mazars USA elects Cody Cass, Julie Petit, and Kristen Walters partners.
• The Boston Globe features ZappRx CEO Zoe Barry in a profile on women in technology.

Blog Posts

• Are Retail Clinics Empowering Patients or Fragmenting Care? (Definitive Healthcare)
• Connect 17 Recap: A Spok Customer’s Firsthand Perspective (Spok)
• 4 Questions with Terri Couts, VP of Clinical Systems and Epic Program, The Guthrie Clinic (Optimum Healthcare IT)
• Beating Breast Cancer: My Journey to a Cancer-Free, Passion-Fueled Life (Salesforce)
• Hospital Closures Continue Affecting Patients and Communities (The SSI Group)
• Patient Retention: 10 Things You Can Do to Keep Existing Patients Happy! (Solutionreach)
• An Unwavering Commitment to Protecting Information (TransUnion)
• Trick or treat: solving the spooky RAPS/EDS transition challenge (Verscend Technologies)
• Seven Elements of Effective Clinical Communication (Vocera)
• Is the Future of Healthcare in Hospitals? (Huron)
• 5 Key Steps to Build a Good Bot (West Corp.)
• Can a Health System’s Digital Presence Help Prevent Referral Leakage? (Wiser Together)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 10/27/17

Top News

President Trump declares a public health emergency to address the country’s opioid crisis, drawing fire from critics for not allocating new funding to address the epidemic. Key takeaways:

• Expanded access to telemedicine services.
• Easier appointments of temporary HHS officials who will help redirect programs and resources.
• Refocusing resources within HIV/AIDs programs to help give patients access to substance abuse treatment.
• Issuing grants to help workers displaced from the workforce by the opioid crisis – a somewhat nebulous benefit subject to available funding.

HIStalk Announcements and Requests

This week on HIStalk Practice: Greenway announces corporate, software overhaul. Oklahoma physicians prepare for major business changes ahead of looming Medicaid cuts. AMA President-Elect argues for less spending on hospitals, and more on primary care. AMA continues to eschew digital health snake oil comments with launch of new forum. CoinMD looks to create a cryptocurrency-based healthcare membership network. Pennsylvania helps prescribers connect EHRs to PDMP. Delaware taps HMS to help it better integrate behavioral health and primary care. Drchrono develops urgent care-friendly health IT.

Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Cerner reports Q3 results: Revenue up 8 percent, adjusted EPS $0.61 vs. $0.59, with bookings down due to projects delayed to the fourth quarter. President Zane Burke is optimistic the company will achieve its projected 2017 earnings and revenue growth, adding that, “we continue to gain share in the Electronic Health Record replacement market and still have meaningful growth opportunities in revenue cycle and population health.”

Another one bites the dust: HIMSS acquires the rights to the Disruptive Women in Healthcare media company. I’m not sure how much disruption will occur now that it’s been gobbled up by HIMSS, which plans on incorporating its content into its own female-focused media efforts.

Tenet Healthcare (TX) decides not to put itself up for sale, though it will move forward with a strategic review of operations as it struggles to deal with $15 billion in debt. Sources believe the company has instead decided to focus on selecting a new, permanent CEO.

GE considers selling its healthcare IT and transportation businesses in an effort to meet a self-inflicted goal of divesting $20 billion in assets under the watchful eye of fairly new CEO (and former head of GE Healthcare) John Flannery.

People

John McLean (Best Doctors) joins Kyruus as CFO.

American Well hires Harry Kim (Samsung Health) as SVP of strategic partnerships.

Sales

Hackensack Meridian Health (NJ) and Riverside Medical Center (IL) will implement Omnicell medication management and safety solutions including the Epic-friendly XT Automated Dispensing Cabinet.

HCA’s HealthOne (CO) health system selects Philips Wellcentive’s cloud-based informatics platform.

To help improve sepsis outcomes, Mosaic Life Care selects Wolters Kluwer Health’s POC Advisor clinical surveillance and analytics software.

MultiCare Health System (WA) will spend $25 million on a staggered Epic implementation across its three Spokane facilities next year.

Navicent Health (GA) will implement Outcome Health’s patient education technology at its physician group locations.

Technology

NantHealth develops a companion medication adherence app for its Vitality GlowCap smart pill bottle.

ZeOmega announces Medicare Advantage-specific enhancements to its Jiva population health management platform.

Announcements and Implementations

Ozarks Medical Center (MO) implements emergency management communications technology from LiveProcess across its hospital, clinics, and home health providers.

With help from IDSolutions, Henry Ford Health System (MI) adds Vidyo’s virtual visit technology to its Epic workflow.

Pella Regional Health Center will go live on Meditech 6.15 November 1.

Partners HealthCare works with Validic to test out adding blood pressure monitoring data from patient home health devices to its EHR and provider workflows. The organizations plan to move forward with broader device integration and data gathering early next year.

Government and Politics

HHS opens up applications for its Opioid Code-a-Thon, which will be held December 6-7 in Washington, DC. Prizes of $10,000 each will be awarded for solutions that focus on opioid treatment, usage, and misuse prevention.

Innovation and Research

The UCSF Health Informatics team analyzes the movements of 85,000 hospitalized patients seen over three years by mapping EHR patient location and timestamp data. The information was then compared with hospital-acquired infection data in hopes of uncovering unknown transmission hotspots within the hospital. The team realized that patients who entered a particular CT scanner used in the ED were more than twice as likely to become infected with C. Diff than the baseline patient population. As a result, ED staff have been re-trained on how to properly sanitize the scanner.

A majority of hospital CMOs report that post-implementation tech support will be a driving factor in their health IT purchasing decisions next year, according to new research from Black Book. Fifty-three percent of survey-takers believe their current EHR vendor is providing sub-par support. Cerner, Allscripts, Meditech, and McKesson received top support marks, while Stoltenburg Consulting was cited as a top third-party support firm.

Other

Tesla team members install a solar array that has helped restore power to San Juan’s Hospital del Niño. Tesla founder Elon Musk has said the power project is the first of many that will help Puerto Rico recover from two September hurricanes that have left the island without vital resources.

San Diego city officials come under fire for the enlisting the pro bono services of PR firms as they sought to stop the hepatitis A outbreak among the city’s homeless. Critics were especially surprised when the PR reps began attending government planning meetings. “You bring in stakeholders who have an interest in the subject at hand,” said one, “but you don’t usually bring in PR people who can spin it afterwards.”

Sponsor Updates

• MedData and Meditech will exhibit at the ACEP Scientific Assembly October 30-November 2 in Washington, DC.
• Netsmart will exhibit at LeadingAge October 29 in New Orleans.
• Nordic will lead focus groups at the CHIME Fall CIO Forum October 31-November 3 in San Antonio.
• NTT Data Services achieves premier-level service provider status in VMware’s Cloud Provider Program.
• Parallon Technology Solutions and PatientSafe Solutions will exhibit at the CHIME Fall CIO Forum October 31-November 3 in San Antonio.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Perinatal-Neonatal Symposium October 30 in Williamsburg, VA.
• Experian Health will exhibit at the Delaware Healthcare Forum October 31 in Dover.
• PatientPing hires Brad Shaw (Wayfair) as director of engineering.
• PokitDok achieves HITRUST CSF Certified status.

Blog Posts

• Big Data, Machine Learning, and Data Security (Liaison Technologies)
• 4 can’t-miss thought leader podcasts (Meditech)
• Unlocking Answers to Big Questions: Lessons from MGMA Members & Patients in the 2017 Digital Payment Progress Report (Navicure)
• Value-Based Care: Building a Strategy for Improved Outcomes and Lower Costs (Netsmart)
• How Machine Learning Can Improve Patient Eligibility Verification (PokitDok)
• Consultant’s Corner – Geoff Turner (Huntzinger Management Group)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 10/25/17

Top News

Imprivata acquires Caradigm’s identity and access management business for an unspecified amount. Caradigm, a GE Healthcare company, has been in the process of streamlining operations for several years now. It announced workforce reductions in April, and August 2016.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor WiserTogether. The Washington, DC-based company’s treatment guidance platform improves outcomes and satisfaction while lowering cost. People and populations use its Return to Health solution to select the most appropriate and effective personalized treatment option in sharing decision-making with their provider. Condition, symptom, and demographic information is assessed against clinical efficacy and guideline content, treatment costs, provider ratings data, and time-to-recovery guidelines to present treatment options labeled as Poor, Good, and Best. Nearly 90 percent of users choose effective treatments, reducing the use of ineffective tests and treatments by 25 percent in creating a 400-900 percent ROI. The company just announced enhancements that include analytics and reporting that allows healthcare organizations to understand how patients make treatment decisions and which options they are likely to choose. Thanks to WiserTogether for supporting HIStalk.

I came across this video describing how patients can use WiserTogether’s Return to Health tool to find evidence-based treatments that are cost effective.

Webinars

Here is the recording from today’s webinar with ZappRx on improving care and saving time with streamlined specialty drug prescribing.

October 25 (Wednesday) 1:00 ET. “Delivering the Healthcare Pricing Transparency that Consumers are Demanding.” Sponsored by: Health Catalyst. Presenter: Gene Thompson, director, Health City Cayman Islands. Health systems are unlike every other major consumer category in not providing upfront pricing information. Learn how one health system has developed predictable, transparent bundled pricing for most major specialties. Attendees will gain insight into the importance of their quality measures and their use of actual daily procedure costing rather than allocated costs. They will also learn about the strategic risk of other market participants competing with single bundled pricing. The organization’s director will expand how its years-long process is enabling healthcare delivery reform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Select Medical Holdings will combine its Concentra occupational and urgent care company with California-based Dignity Health’s US HealthWorks subsidiary as part of an expanding partnership that includes the joint development of a 60-bed hospital and operation of 12 outpatient clinics in Las Vegas.

Life insurance company John Hancock dangles $25 Apple Watches to lure customers into its Vitality health and wellness program. Members who exercise regularly for two years will avoid having to pay off the typically $300 device in installments.

Nuance points the legal finger at MModal, alleging in a lawsuit that MModal products violate patents pertaining to transcription, speech recognition, and computer-assisted physician documentation technology. The lawsuit comes four months after Nuance suffered a malware attack on its cloud-based services that led to a $15 million loss in Q3.

Newton, MA-based Devoted Health raises $62 million, bringing its total to $69 since launching earlier this year. Company founders Ed and Todd Park (brothers of Athenahealth fame, among other illustrious health IT roles) plan to offer concierge-style Medicare Advantage plans beginning in 2019 that will incorporate house calls and virtual visits.

Amazon receives 238 bids from 54 states, provinces, and territories all vying to attract the company’s second headquarters. Amazon plans to invest $5 billion in the new facility, which will employ 50,000. Given its recent interest in health IT, it will be interesting to see if “Amazon HQ2” lands in a health IT-heavy town. As one would expect, city officials have dangled tax breaks and other incentives in front of the world’s largest online retailer. Outside of Atlanta, City of Stonecrest Mayor Jason Lary has promised to develop the city of Amazon and appoint Jeff Bezos as its lifelong mayor. 

Reuters reports that Siemens has enlisted three banks to lead the organization of an early-summer IPO for its Healthineers unit.

Announcements and Implementations

Regional Health (SD) goes live on Epic over the weekend.

Swedish Bellevue Primary Care (WA) becomes the fourth Swedish location to roll out Versus Technology’s real-time locating system.

Definitive Healthcare adds retail clinics and assisted living facilities to its market research database of providers.

Thibodaux Regional Medical Center (LA) implements electronic signatures and forms technology from Access.

People

Tom Visotsky (HCS) joins Kno2 as VP of vertical market sales.

Cancer informatics company Inspirata names Josh Mann (Mann Consulting & Ventures) VP of its Cancer Information Data Trust Program.

Vikram Natarajan (Medfusion) joins SPH Analytics as SVP of development and IT.

Tenet Healthcare names Executive Chairman Ronald Rittenmeyer interim CEO. He takes over from Trevor Fetter, who announced his resignation in August after a two decade career at the Dallas-based health system. Tenet has been exploring strategic options recently, including the potential sale of parts of the company, and has been in the public eye over disagreements with investors over strategy, takeover rumors, and board-level resignations.

Technology

Medecision debuts new care management apps related to population analytics, EHRs, financial performance, risk scoring, and care coordination. The company will launch apps for care engagement and operational efficiencies later this year.

Government and Politics

Ft. Lewis, WA-based Madigan Army Medical Center goes live on Cerner, the fourth major installation of the DoD’s MHS Genesis program. The center is the largest of the program’s inpatient facility implementations, and the final one in the Pacific Northwest. I like that they’ve gotten a patient to host their tutorial videos, the first of which is accompanied by an 80’s-era soundtrack that will have you reminiscing about Jazzercise and GI Joe quicker than you can say “New Coke.”

A federal court dismisses CliniComp’s August lawsuit against the VA, which alleged that the administration had improperly issued Cerner a no-bid contract for a VistA replacement. CliniComp CEO Chris Haudenschild has vowed to appeal, adding that the company “simply wants the chance to prove that it can do the job cheaper, faster, and better.” The company’s systems are used in several VA hospitals.

Innovation and Research

The COPD Foundation, Geisinger (PA), GSK, and Jvion embark on a project that will identify COPD patients at risk of hospitalization and/or readmissions. Funded by GSK, the two-phased project will pair the foundation and Geisinger’s clinical expertise with Jvion’s AI-based patient risk stratification technology.

Black Book survey-takers rank Navicure as the top RCM technology vendor, with Experian, Patientco, Change Healthcare, InstaMed, and NThrive also scoring high for end-user satisfaction.

Other 

The New Yorker digs into the pharma moguls of the Sackler family (apparently known more for their philanthropy than to the development of OxyContin) and their ties to the rise of pharmaceutical advertising, which some physicians feel account for the lion’s share of today’s opioid epidemic.

This is a breach of a different kind: Saline Memorial Hospital staff receive an unexpected (and no doubt unruly) visitor when a deer crashes into its courtyard, prompting Arkansas Game and Fish to come and remove the animal.

Sponsor Updates

• Besler Consulting releases a new podcast, “Reducing Medicare spending through electronic health information exchange.”
• Carevive wins the 2017 Cerner Emerging Partner of the Year Award.
• Centrak will exhibit at LeadingAge October 29-November 1 in New Orleans.
• CoverMyMeds will exhibit at the CBI Electronic Benefit Verification and Prior Authorization Summit October 24-25 in San Francisco.
• Dimensional Insight will exhibit at the Hospital Quality Institute November 1-3 in Monterey, CA.
• EClinicalWorks will exhibit at the Connected Health Conference October 26-27 in Boston.
• FormFast, HealthCast, Impact Advisors, InterSystems, and Intelligent Medical Objects will exhibit at the CHIME CIO Fall Forum October 31-November 3 in San Antonio.
• Healthwise will exhibit at the HealthTrio 2017 Users Group Conference October 25-27 in Tucson.
• Optimum Healthcare IT publishes a new case study, “Epic Help Desk and Call Center Support at The Guthrie Clinic.”
• Iatric Systems will exhibit at the HCCA Regional Conference October 27 in Chicago.
• AdvancedMD, Clinical Architecture, and CompuGroup Medical join CommonWell.
• Nordic releases a new podcast, “How to communicate effectively during your EHR transition.”

Blog Posts

• Guess Whose eSignature Solution Meditech Uses? (Access)
• Difference between Machine Learning, Data Science, AI, Deep Learning, and Statistics (Agfa Healthcare)
• Mapping Digital Health: an Interview with Strata Health Executive VP Peter Smith (Datica)
• CEO Perspective: CarePort as a Company (CarePort)
• Chronic Care Management: Choosing the Right Care Coordination Company (CareSync)
• How Physician-Owned Practices can Generate Great Patient Reviews (ChartLogic)
• Understanding Customer Experience at Diameter Health (Diameter Health)
• How nurse-performed ultrasound is improving patient care and nursing efficiency (Elsevier Clinical Solutions)
• Innovations From Our National Conference (EClinicalWorks)
• Why You Should Consider Outsourcing Your Legacy Support During a System Implementation (Hayes Management Consulting)
• Management of Enterprise IT in Healthcare Environments (The HCI Group)
• How Consumers Can Use The National Health Index to Navigate Their Care Journey with Confidence (Healthgrades)
• What Works – Data Analytics and Business Intelligence Assessment Results in Strategic Roadmap and an Actionable Plan for Success (Huntzinger Management Group)
• EHR Satisfaction Survey 2017 – Do You Agree with the Results? (Iatric Systems)
• What is Master Data Management and Where Should I Start? (Impact Advisors)
• Is the Quality Payment Program the most disruptive feature of MACRA? (Imprivata)
• Creating More Effective Healthcare Ads (Influence Health)
• Why Are We Still Talking About EMV Two Years After the Liability Shift? (InstaMed)
• Revenue Cycle Readiness: Looking Beyond the Numbers (Leidos Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 10/23/17

Top News

Athenahealth shares jumped over 8 percent Friday following Thursday’s announcement of mixed financial results, layoffs, office closures, and a cost reduction plan.

From Friday’s Athenahealth earnings call:

• Jonathan Bush says that the company’s slowing growth rate is due to “lackluster market conditions in the post-Meaningful Use era” as overall buying activity has dropped off. It hopes to generate 15 percent revenue growth for 2018.
• The company blames its revenue expectations miss on having one fewer working day in Q3 as well as hurricane-related usage decreases. It also notes that visits per provider are dropping.
• Workforce reductions of 9 percent of the company’s total headcount will be completed by the end of 2017, with the goal of removing management layers and increasing employee engagement. The company “right-sized” sales and marketing and “rationalized” general and administrative support.
• Bush says “We’re sharpening our focus, taking action to operate in a significantly more efficient way, and move faster on our highest-value strategic objectives.”
• The company will close its San Francisco and Princeton, NJ offices, rent out office space freed up by the layoffs, and sell its Challenger 300 jet.
• The company is still recruiting an independent board chair, CFO, and president.
• Athenahealth has 56 small hospitals live and has retained 95 percent of the hospitals brought live on AthenaNet since entering the market three years ago.
• Bush credits the pressure brought by an activist investor for causing the management team to “look at the company through different eyes” and for “helping us find our way.”
• Population health and Epocrates are not keeping up with the core business growth.
• The company expects to connect with 100 percent of Epic’s installed based and 45 percent of Cerner’s this year.
• Bush said hospitals say, “I hope somebody buys Epic or whatever it is after me so I don’t have to be the last guy who went and put half a billion dollars into enterprise software in 2017.”

HIStalk Announcements and Requests

Two-thirds of poll respondents say not having a national patient identifier is a pretty big problem.

New poll to your right or here: How much impact will IBM Watson have on healthcare?

Ms. B reports that her North Carolina middle schoolers “couldn’t keep their hands off” the science activity tubs we provided in funding her DonorsChoose teacher grant request.

This Week in Health IT History

One year ago:

• McKesson says it will take a $290 million write-down of its Enterprise Information Systems business as it continues to seek a buyer for the division that includes Paragon.
• Vocera acquires Extension Healthcare.
• Jonathan Bush admits in the Athenahealth earnings call that followed a revenue miss that shifts in the market mean the company cannot maintain 30 percent bookings growth.

Five years ago:

• An OIG report finds that the VA paid $6 million for 400,000 PC encryption licenses but has installed them on only 65,000 devices.
• Apple announces the iPad Mini.
• Allscripts sues Aprima for using the MyWay name in advertising aimed at getting those customers to switch to Aprima.
• Athenahealth confirms that is negotiating with Harvard University to purchase the 11-building Arsenal on the Charles complex in Watertown, MA.

Ten years ago:

• Misys creates an open source division to which it contributes its Connect software.
• Misys announces MyWay, a hosted EHR it licensed from iMedica.
• Medsphere CEO Mike Doyle predicts that the company will be the largest healthcare IT vendor.
• Microsoft and HIMSS announce an overseas expansion of the MS-HUG conference.

Last Week’s Most Interesting News

• Athenahealth announces big layoffs and planned expense reductions in response to pressure from an activist investor.
• CVS and Epic will implement Epic’s Healthy Planet software to give prescribers point-of-care formulary and pricing information.
• President Trump signs two executive orders to further destabilize the ACA, declaring that Obamacare no longer exists.
• A state audit finds that University of Utah violated state procurement laws in its dealings with Patrick Soon-Shiong’s Nant companies.

Webinars

October 24 (Tuesday) 1:00 ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 25 (Wednesday) 1:00 ET. “Delivering the Healthcare Pricing Transparency that Consumers are Demanding.” Sponsored by: Health Catalyst. Presenter: Gene Thompson, director, Health City Cayman Islands. Health systems are unlike every other major consumer category in not providing upfront pricing information. Learn how one health system has developed predictable, transparent bundled pricing for most major specialties. Attendees will gain insight into the importance of their quality measures and their use of actual daily procedure costing rather than allocated costs. They will also learn about the strategic risk of other market participants competing with single bundled pricing. The organization’s director will expand how its years-long process is enabling healthcare delivery reform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Global health research network operator TriNetX will expand its Cambridge, MA office space as its headcount has expanded from 20 to 75. The new 20,000 square foot space will also include a network operations center.

Harris Healthcare acquires practice management software vendor Clinix Medical Information Systems.

Sales

Population health management services provider HMC HealthWorks will implement Medecision Aerial applications that include analytics, financial performance dashboards, care management, evidence-based clinical programs, and personal health record.

In Dubai, UAE, Latifa Hospital for Women and Children chooses Vocera’s intelligent communication technology.

Decisions

• Fort Madison Community Hospital (IA) will replace Greenway’s ambulatory EHR with Meditech in 2018.
• Women’s Healthcare Associates (OR) will switch from GE Healthcare to Epic’s ambulatory EHR in May 2018.
• Palmetto Health (SC) will replace McKesson Star with Cerner revenue cycle management in October 2018.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.

Announcements and Implementations

ZeOmega launches a Jiva certification program for third-party consultants

Government and Politics

Wisam Rizk, former CTO of Cleveland Clinic Innovations spinoff Interactive Visual Health Records, is arrested for defrauding the clinic of $2.8 million. The charges came nine days after former Cleveland Clinic Innovations Executive Director Gary Fingerhut pleaded guilty and agreed to serve federal prison time for accepting $469,000 from Rizk in return for lying to the FBI during their fraud investigation. Prosecutors say Rizk created a shell company that he hired to develop IVHR’s medical charting product at an inflated price, then contracted with an offshore company to do the actual work and pocketed the difference.

Privacy and Security

Computer systems of FirstHealth of the Carolinas (NC) have been offline for several days following a ransomware attack that it attributes to “a new form of the WannaCry virus.”

An interesting research project finds that anyone willing to pay $1,000 for online ads can track a mobile phone user’s movements, their precise location in near real time, and the apps they use, as long as they can obtain that person’s mobile advertising ID by examining their phone or eavesdropping on their wireless connection. The target doesn’t even need to click the ads – just having the ads displayed on their device records the information. Advertisers are already receiving this information, of course.

Other

Anesthesiologist and Georgia state representative Betty Price, MD – who is married to fired HHS Secretary Tom Price – asks a state public health official in a public meeting if it would be legal to prevent the spread of HIV by quarantining people who have it. She flaunts clinical expertise in noting that dead HIV sufferers can’t spread it: “It’s almost frightening the number of people who are living that are … carriers with the potential to spread. Whereas in the past, they died more readily, and then at that point, they’re not posing a risk. So we’ve got a huge population posing a risk if they’re not in treatment.”

Sponsor Updates

• Liaison Technologies makes its Alloy platform available in Europe.
• MedData will exhibit at the Ohio AAP 2017 Annual Meeting October 27 in Columbus.
• Colquitt Regional recognizes the benefits of Meditech’s EHR in a new video.
• Navicure and Surescripts will exhibit at the Centricity Healthcare User Group Fall 2017 October 26-28 in New Orleans.
• Madison Magazine recognizes Nordic President of Managed Services Vivek Swaminathan as an innovative leader.
• Experian Health will exhibit at the HFMA First Illinois Fall Summit October 24-25 in Oakbrook Terrace.
• Patientco CEO Bird Blitch aims to make the company a “Best Place to Work in Atlanta.”
• T-System will exhibit at the 2017 Urgent Care Fall Conference October 26-28 in Anaheim, CA.
• ZirMed will exhibit at the 2017 MedTrade Fall Conference October 23-26 in Atlanta.

Blog Posts

• The Data Differentiator: How Data is Driving Digital Transformation (Liaison Technologies)
• CMS Emergency Preparedness Rule Takes Effect – Are You Ready? (LiveProcess)
• Healthcare Revenue Cycle Management 101: The Patient is Paramount (MedData)
• 3 strategies for success in the rapidly changing home care landscape (Meditech)
• No Need to Fear Your Revenue Cycle This Halloween (Navicure)
• Success in Long-Term Care Through Care Coordination (Netsmart)
• Next-Generation GPUs: Driving Innovation in Speech Technology and Beyond (NVoq)
• IntegraTe 2017 – Doing More with Less and Hospital Workflow Processes (PatientSafe Solutions)
• Change vs. Transformation (PatientKeeper)
• Healthcare AI Will Survive Its Hype Cycle (Redox)
• How to Succeed in Sales as an Introvert (Salesforce)
• What Works – Data Analytics and Business Intelligence Assessment Results in Strategic Roadmap and an Actionable Plan for Success (Huntzinger Management Group)
• Unleashing the Power of Patient Newsletters (Solutionreach)
• Seven Elements of Effective Clinical Communication (Vocera)
• Lessons for a First Time CEOs to Choosing Board Members – Part 1 (ZappRx)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 10/20/17

Top News

Athenahealth announces Q3 results: revenue up 10 percent, adjusted EPS $0.56 vs. $0.60, beating earnings expectations but falling short on revenue.

The company announced that it will lay off 9 percent of its workforce in cutting a reported 450 jobs. Boston newspapers cited sources who said they saw security officers escorting people out of the company’s Watertown, MA offices Thursday morning.

Athenahealth is undertaking a strategic review, pressured by an activist investor, expecting to generate up to $115 million of annual pre-tax savings by the end of 2018.

As part of the cost-cutting program, Athenahealth will close its offices in San Francisco, CA and Princeton, NJ, both of which house employees of Epocrates, the drug information app company that Athenahealth acquired for $293 million in January 2013.

Anonymous people posted on an Internet layoff discussion board that the company is selling its jet as well as the 387-acre Point Lookout resort in Maine that it bought for $7.7 million in 2011 as a training and entertainment venue.

ATHN shares dropped 4 percent during Thursday’s trading and were down another 4 percent in early after-hours trading.

HIStalk Announcements and Requests

NYC Health + Hospitals took exception to my mentioning a recent article in the New York Post headline above, with its complaints below. I’m sympathetic since I don’t usually run one-sided lawsuit recaps, especially of the “he said, said” variety, but several readers had sent this link over with obvious interest and I saw it popping up in a lot of places, so I simply recapped the Post story.

• “The lawsuit had nothing to do with sexual harassment.” That’s true and I’ve corrected my wording. I said in considerable detail that the lawsuit was related to wrongful termination, but I worded the part poorly where I referred to sexual harassment – the Post article focused on that, but the lawsuit itself didn’t.
• “The former IT director was never deposed.” The Post story said he was and quoted what it said was his sworn testimony directly, so I had no reason to doubt that.
• “The actual lawsuit alleging wrongful contract termination was dismissed.” That wasn’t mentioned in the Post article, which references an “ongoing gender discrimination case” that doesn’t make it clear whether she filed one lawsuit or two. I don’t have access to court records unless I can turn something up by Google searching for something that isn’t behind a paywall, which I didn’t in this case. I did turn up the OIG report item not mentioned in the Post article that was mostly favorable to the health system and summarized that, which the Post article did not.
• “You make it appear as though it is your original reporting, which would be WRONG, WRONG, WRONG.” I linked to the Post article like I do all news item I cite, so I can’t imagine anyone thinking I was writing from a New York courtroom instead of my stereotypical blogger’s spare bedroom.

Listening: The Tragically Hip, thoughtfully rocking with an intact lineup as the pride of Canada since 1994 until this week, when front man Gord Downie died of brain cancer at 53. Reaction to his death has overtaken the Toronto newspaper, but an article written last year about what turned out to be the band’s final tour is the most poignant. Prime Minister Justin Trudeau delivered a tear-filled tribute to Downie, declaring, “We are less as a country without Gord Downie.”

Amazon’s continuous rollout of features amazes me. Last night I received a text message indicating that my package had been delivered, complete with a driver-taken photo of the item sitting on my doorstep. I’m not sure why I need it other than that it answers the question of whether the delivery went to the mailbox or to the doormat, but it’s cool.

This week on HIStalk Practice: EHR-related medical malpractice claims continue to increase. PatientPop ramps up Google-related physician marketing capabilities. Health Affairs offers context around OIG’s ACO analysis. Pine Rest Christian Mental Health Services goes with Epic. Walgreens brings 300 jobs to staff its new technology center of excellence. Medsphere acquires Stockell Healthcare Systems. Texas Medical Association begins doling out disaster relief funds to wiped-out practices. PRM Pro Jim Higgins offers practical solutions for physician tech-integration challenges.

Webinars

October 24 (Tuesday) 1:00 ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 25 (Wednesday) 1:00 ET. “Delivering the Healthcare Pricing Transparency that Consumers are Demanding.” Sponsored by: Health Catalyst. Presenter: Gene Thompson, director, Health City Cayman Islands. Health systems are unlike every other major consumer category in not providing upfront pricing information. Learn how one health system has developed predictable, transparent bundled pricing for most major specialties. Attendees will gain insight into the importance of their quality measures and their use of actual daily procedure costing rather than allocated costs. They will also learn about the strategic risk of other market participants competing with single bundled pricing. The organization’s director will expand how its years-long process is enabling healthcare delivery reform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Medsphere acquires its long-time revenue cycle implementation partner Stockell Health Systems, which will retain its name as a division of Medsphere.

Population health management system vendor BaseHealth receives an $8.5 million investment in a Series C funding round, increasing its total to $18 million. 

Medical image virtual reality software vendor EchoPixel raises $8.5 million in a Series A funding round, increasing its total to $14.5 million. I declared it the coolest product I saw (and played around with) at HIMSS16.

Sales

Community Health Network (IN) will implement Stanson Health’s clinical decision support and analytics.

Liberty Regional Medical Center (GA) and Veterans Memorial Hospital (IA) will replace an unnamed vendor (a reader with HIMSS Analytics access says it is Athenahealth) to return to the Evident Thrive EHR of CPSI. CPSI will also gain two McKesson/Allscripts Paragon customers as Thrive EHR users – Jenkins County Medical Center (GA) and Monroe Regional Hospital (MS).

Holy Name Medical Center (NJ) will use CareCloud’s EHR/PM in its 35 ambulatory medical practices. The hospital’s inpatient systems were mostly developed in-house, which is an outlier in this day and age.

People

Infor promotes Dann Lemerand to VP of strategy and product management of its CX Suite customer.

Kansas state representative Erin Davis joins Cerner as senior government strategist, raising questions about possible conflicts of interest that the company dismisses with the explanation that she will be involved with government sales only in the Northwest.

Secure health information exchange and claims attachment system vendor Vyne hires Robert Patrick (Carestream Dental) to the newly created position of president of its dental division. He will report to Lindy Benton, who remains president and CEO of Vyne.

John Mangano (Digitas Health) joins Healthgrades as SVP of business intelligence.

Announcements and Implementations

Lexmark announces GA of Downtime Assistant for Healthcare, which refreshes the hard drives of the company’s multi-function printers with EHR-generated reports, forms, and checklists that are needed for patient care when the EHR is down.

Treatment guidance solution vendor WiserTogether adds reporting and analytics to its Return to Health product, giving healthcare organizations insight into patient behavior that can be used to create pathways.

Intel launches its Health Application Platform platform that is integrated with a stable, secure Android edge device from Flex to connect consumer health monitoring devices to support remote care delivery.

Apple and GE release a software development kit for GE’s Predix Internet of Things platform that will allow developers to create industrial IoT apps for the iPhone and iPad. GE will also promote Macs for its 330,000-employee workforce, which would surely be the largest corporate deployment of Macs ever if they actually swap them all out.

Government and Politics

A state audit finds that University of Utah violated procurement laws in accepting a $12 million donation from Patrick Soon-Shiong that required the university to spend most of that money buying genetic sequencing tests from Soon-Shiong’s Nant companies. Auditors said the university let Soon-Shiong create specifications that assured a no-bid contract, also noting that competing companies could have provided the same genetic sequencing services for one-third the price.

The FBI arrests “Dr. Dave,” a Fort Worth personal trainer who registered as a CMS provider under 19 phony names in fraudulently billing $25 million to insurance companies. 

Privacy and Security

Iliuliuk Family and Health Services (AK) acknowledges that it was hit by ransomware that “temporarily blocked” access to its systems in August, but doesn’t say if it paid the demanded ransom.

Innovation and Research

JDRF announces an initiative to encourage innovation and family involvement in open-protocol artificial pancreas systems, where it will provide funding and regulatory advice to bring do-it-yourself and reverse engineered diabetes management technology projects to market.

Other

A JAMA editorial questions whether an oversupply of ICU beds has caused overutilization, noting that 1 percent of the entire United States gross domestic product is spent on ICU care, representing half of all US hospital expenses.

In England, a BBC review finds that the registered organ donor wishes of one-third of newly deceased people are not respected because of family objections. The law recognizes only the legal consent of the donor, but NHS says family objections – usually involving the time the process requires — are always upheld, denying hundreds of people the organ transplants they need. A 17-year-old registered donor says, “What’s the point of signing up if I could be overruled anyway?”

A Kaiser Health News report finds that 90 percent of Indiana’s nursing homes have been leased or sold to hospitals that are using a Medicaid loophole to earn a 30 percent higher payment, which in the case of leased facilities is shared with the city or county government owner. Advocates say that rural hospitals use the profit to remain solvent, while critics argue that hospital operators keep residents longer and the federal government is paying more for quality that hasn’t improved. Indiana Medicaid spends two-thirds of its long-term care budget on nursing homes vs. the US average of less than half, but as a state, Indiana is ranked among the worst for nursing home quality. A hospital CEO acknowledges that it makes money from putting more patients into its nursing homes, explaining, “Welcome to healthcare. It’s a complex and confusing environment where we have all different competing incentives.”

A local paper’s review of Vermont’s history as a health IT hub gives a nod to Rich Tarrant and Robert Hoehl’s Burlington Data Processing — later renamed to IDX Systems and then sold to GE Healthcare in 2006 for $1.2 billion – whose profits allowed some employees to fund new startups. Companies mentioned include Ona, ThinkMD, OhMD, Galen Healthcare Solutions, and Physician’s Computer Company.

This is hard to believe: an inmate with the porn-like name Dustin Lance sues the county jail for $5 million, claiming staff ignored his pleas for medical help after he swallowed a pill given to him by another inmate that caused him to have a painful erection that lasted 91 hours.

Sponsor Updates

• Optimum Healthcare IT publishes an infographic titled “Rules of Thumb, Benefits, and Dangers of EHR Alerts.”
• EClinicalWorks will exhibit at the 2017 TAHP Managed Care Conference & Trade Show October 23-24 in Houston.
• FormFast will exhibit at the 2017 Fall HCP Hospital & Healthcare IT Conference October 18-19 in Chicago.
• MModal is named 2017’s s health IT innovation leader by the Pittsburgh Technology Council.
• Healthwise will exhibit at the HealthTrio 2017 Users Group Conference October 25-27 in Tucson.
• Greg Walton of Next Wave Health Advisors, a Huntzinger Management Company, becomes a Life Fellow Member of HIMSS.
• Iatric Systems will exhibit at the Midwest Fall Technology Conference October 22-24 in Indianapolis.
• Surgical Products nominates Image Stream Medical’s MedPresence solution for the 2017 Excellence in Surgical Products Awards.
• Impact Advisors VP Lydon Neumann becomes a CHIME Foundation Certified Healthcare Executive.
• Imprivata collaborates with Welch Allyn to enhance security for medical devices
• InterSystems will exhibit at RSNA 2017 October 26-November 1 in Chicago.
• Kyruus will present at the Healthcare Internet Conference October 23-25 in Austin.

Blog Posts

• Healthcare AI Will Survive Its Hype Cycle (Redox)
• The solution to physician burnout? Don’t blame the EHR, optimize it (Nordic)
• 36 hours of hacking medicine at Johns Hopkins MedHacks 2017 (Elsevier Clinical Solutions)
• How to Minimize Chaos in Your Central Business Office During a System Transition: 4 Steps for Success (Hayes Management Consulting)
• Achieving Cost Savings with Healthcare IT Managed Services (The HCI Group)
• Guess Whose eSignature Solution Meditech Uses?e (Access)
• Update on HIPAA Audits, from an Insider (Iatric Systems)
• Denials Management: Going from Zero to Hero (Impact Advisors)
• Be the Hero: Skills for Healthcare IT (Influence Health)
• Huntzinger Congratulates Geisinger’s John Kravitz on Being Appointed to the CHIME Board of Trustees (Huntzinger Management Group)
• Healthcare’s Roadmap for Payment Assurance: Why it’s All About Where You Keep Your Data (InstaMed)
• How to identify HCC patients for better care, reimbursement (Intelligent Medical Objects)
• ATLAS 2017 Key Takeaways on Transforming Patient Access (Kyruus)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 10/18/17

Top News

Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) release their bipartisan plan to stabilize the health insurance exchanges in the short term. It quickly earned President Trump’s blessing “to get us over this immediate hump.”

Reported terms of the plan, announcement of which without specific draft language sent healthcare stocks flying on Tuesday, include:

• Payment of the ACA cost-sharing reductions that the President just ordered to be stopped would be reinstated for two years.
• $100 million of ACA sign-up assistance would be restored.
• The waiver process for states that want to customize ACA rules would be simplified.
• The availability of high-deductible, less-expensive policies would be expanded to all ACA enrollees, not just those under 30 years of age.

Vocal ACA supporter Andy Slavitt, former CMS acting administrator, is a fan of the Murray-Alexander proposal (even though he frets that it won’t get passed or that Senate Republicans won’t stop their quest to repeal the ACA entirely) since it would:

• Preserve the ACA.
• Reverse some of the White House’s ACA “sabotage.”
• Provide new affordable plan options that, while not for everyone, are still better than no insurance.
• Bring healthier people into the market.
• Give states the flexibility they have been demanding while protecting lower income and sicker populations.

Reader Comments

From Lingua Frank: “Re: grammatical errors. I recently heard a cyberscurity expert talking about ‘security tenants,’ which I assume was supposed to be ‘tenets.’ An HIT project manager described dividing a project into ‘epics’ instead of ‘epochs.’” I was about to rail about colleges that graduate students who are poor writers, but I realized that the real culprit is a culture that accepts poor grammar and writing, as well as sloppy presenters and writers who indignantly insist that we stop grammar Nazi-ing them and instead serve as their auto-correct by proxy. Facebook has taught me to immediately stop reading posts from people I don’t know personally that feature misspelled words or hideously bad grammar since I have to assume that the person is equally lazy in their logic and execution. We all make mistakes, but only some of us care enough to fix them. I’m not as militant about mistakes like these two examples since it’s easy to misuse similar-sounding words especially when you hear them more often than you read them, and if you don’t know the difference between the words, no amount of spell-check will help.

From Peony: “Re: Allscripts. The press release mangles the name of their new customer, Catholic Medical Center.” Indeed it does, but at least only after listing the name correctly six times. “Care Medical Center” is actually a pretty good name.

HIStalk Announcements and Requests

I was curious about the five-year share price performance of some of the publicly traded health IT vendors. Buying Cerner or Athenahealth would have earned you a five-year return of around 85 percent, while Allscripts and Quality Systems were dead money and buying CPSI would have lost you 40 percent over five years. With 20-20 hindsight, you would have passed on these and instead bought index funds for the S&P 500 (up 78 percent) or the Nasdaq (up 120 percent), both of which provided great returns without the white-knuckle share price rollercoaster thrills along the way. Click the chart above to enlarge.

Listening: new from Mostly Autumn, an English progressive rock band (Pink Floyd-ish at times) formed in 1995 mostly known for near-constant touring, not signing with a big record label, and having a considerable turnover of personnel that has necessarily changed their sound over time. YouTube made a good related suggestion in 4th Labyrinth, which in addition to playing decent pop-tinged prog rock, has one of the most mesmerizing bass players you’ll ever see in Claudia McKenzie (they do a nice cover of “Locomotive Breath.”)

Webinars

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester:  What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

October 24 (Tuesday) 1:00 ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 25 (Wednesday) 1:00 ET. “Delivering the Healthcare Pricing Transparency that Consumers are Demanding.” Sponsored by: Health Catalyst. Presenter: Gene Thompson, director, Health City Cayman Islands. Health systems are unlike every other major consumer category in not providing upfront pricing information. Learn how one health system has developed predictable, transparent bundled pricing for most major specialties. Attendees will gain insight into the importance of their quality measures and their use of actual daily procedure costing rather than allocated costs. They will also learn about the strategic risk of other market participants competing with single bundled pricing. The organization’s director will expand how its years-long process is enabling healthcare delivery reform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

CNBC reports that Apple was recently considering acquiring its on-site medical clinic operator Crossover Health or national primary care clinic One Medical, although the sources did not indicate whether Apple’s interest was in running health clinics (which would be huge mistake and one that Apple is too smart to make) or partnering with them in an unstated technology role. The article describes Crossover Health  as a startup, which might stretch the term since the venture-backed company was founded in 2006 by Medsphere co-founder Scott Shreeve, MD after Medsphere bizarrely fired and sued him and his Medsphere co-founder brother Steve for publicly releasing source code, an odd move for an open source software vendor. Crossover Health has raised $114 million, runs four locations in Silicon Valley and one in New York City, and Scott remains as CEO, which I think takes it beyond the “startup” label.

Non-profit accelerator BioEnterprise Corp.will take over management of Cleveland’s county-owned, money-losing Global Center for Health Innovation. The building, which is attached to a convention center, changed its name from the less-sexy Medical Mart before it opened to a collective yawn in 2013. HIMSS signed on early as the anchor tenant.

Eye Care Leaders, which sells EHR/PM for ophthalmologists and optometrists, acquires competitor IMedicWare.

Sales

Adventist Health System will implement Glytec’s EGlycemic Management System at 39 of its hospitals.

Three hospitals in Belgium choose Cerner Millennium, although the company already announced University Hospital of Antwerp early this year.

CVS – whose MinuteClinic and specialty care management programs use Epic — will implement Epic’s Healthy Planet population health and analytics platform to give prescribers point-of-care information about drug formulary status, suggest lower-cost alternatives, and perform electronic prior authorization. The integration will also send a patient’s non-prescription drug purchases made via digital store front to their record in Epic’s EHR .

China-based Internet technology vendor Tencent – whose messaging apps are used by two-thirds of China’s population – will offer its users evidence-based consumer healthcare information from Healthwise that it calls “the best health information in the world.” 

Catholic Medical Center (NH) will implement Allscripts CareInMotion for population health management.

Announcements and Implementations

The American Medical Association launches its Integrated Health Model Initiative that will attempt to create a physician-developed holistic common data model around topics such as function, state, and goal to apply medical knowledge and improve interoperability. Initial communities are hypertension management, diabetes prevention, asthma functional status and patient goals, and defining wellness. Collaborators include AAFP, the American Heart Associaation, AMIA, Apertiva, BioReference Laboratories, CareCloud, Cerner, Clinical Architecture, IBM, Intermountain Healthcare, PCORI, PCPI, Prometheus Research, and SNOMED International. The announcement contained a lot of vague, lofty statements, so what AMA will actually do is not obvious.

Bernoulli Health will expand into Canada to offer its device integration, continuous monitoring, and clinical surveillance solution.

Healthgrades publishes its 2018 analysis of the top quality US hospitals and its “Report to the Nation.” It finds that if all hospitals performed as well as its five-star hospitals, 220,000 lives would be saved each year. Also released is the company’s National Health Index that lists the country’s 25 healthiest cities, with Minneapolis-St. Paul, Denver, Sacramento, Cincinnati, and Portland, OR taking the top five spots.

Voalte and Lightning Bolt Solutions will integrate their respective caregiver communications and hospital physician scheduling systems.

Government and Politics

President Trump declares in a Monday cabinet meeting that the term Obamacare is obsolete, explaining, “Obamacare is finished. It’s dead. It’s gone. It’s no longer. You shouldn’t even mention it. It’s gone. There is no such thing as Obamacare any more.” I’ll take all wagers that the President himself will tweet that term within a few weeks in trying to blame someone else for the inevitable “Trumpcare” meltdown.

Meanwhile, UnitedHealth Group says it’s excited about selling short-term medical plans again per the President’s executive order that extends their maximum coverage period from three months to one year. Investors loved the company’s reaction, which probably means prospective customers should be wary given the history of those policies excluding of pre-existing conditions (even if the insured person doesn’t know about them) and generating consumer complaints and lawsuits.

Politico reports that Seema Verma and Scott Gottlieb have fallen off President Trump’s short list to replace Tom Price as HHS secretary, with the frontrunner now being Alex Azar, a former HHS deputy secretary (basically HHS’s COO) who ran drug maker Lilly’s US operations until he left the company in January.

Three New York City doctors are sentenced to two years in prison for accepting cash, strip club tabs, and sex acts in exchange for referring patient blood samples to a private New Jersey lab company. Fifty people have been convicted so far, 36 of them doctors, for a bribery scheme run by Biodiagnostic Laboratory Services that improperly steered $100 million in Medicare and insurance payments to the company.

Privacy and Security

Chase Brexton Health Care (MD) notifies 17,000 patients that four of its employees fell for a phishing scam by filling out a phony email survey that gave hackers access to their email accounts. The hacker re-routed the paychecks of those employees to their own bank account. In terms of exposed PHI, the FQHC said the employee email accounts contained a lot of it that triggered the breach notice, but didn’t explain further.

Other

Venture capitalist Vinod Khosla famously said years ago that computers would replace doctors, which I thought was arrogant, clueless blather until I read this new interview with him that goes beyond the sound bite in elaborating on his thought process. Snips:

• [On why he said we need algorithms rather than doctors] “I tore my ACL skiing … I did an MRI and I took it to three different docs and they recommended three different things. I said, this is stupid. There’s one right answer. When I talked to them about probability, they didn’t understand probability, and these are really good docs.”
• “NNT (number needed to treat) is an incredibly important number that few doctors are aware of … If (medicine) was a science, for any given patient, you’d always have the same answer no matter who you ask, even if it is a probability distribution of outcomes. My goal became to change the practice of medicine, which is pretty damn good, into the science of medicine.”
• “We don’t even measure the stuff that doctors can’t directly understand. We’re starting to run into this a little bit because in genomics, you might get 1,000 data points and no doctor can look at 1,000 data points. So in the past, we didn’t measure anything humans couldn’t consume, which meant they can at best look at a few numbers. We should have thousands of numbers per patient, per episode.”
• “Anything that’s computing-based is near zero cost eventually. Which is why we spend way more compute cycles on a two-cent ad on Google than $10,000 medical decisions like, do you need a meniscus repair? … Let’s say you’re dealing with something serious like colon cancer. Does he know what each of the thousands of mutations could be? No, he doesn’t. So when he’s sitting down with the patient and saying, ‘You’ve got this cancer mutation,’ does he remember the 5,000 papers published in oncology journals recently? No, he doesn’t. He can’t.”
• “There’s a company in Israel called Zebra Medical Vision (note: Khosla is an investor in the company)… In India today, they are offering reading any image for a dollar. Now that’s impactful. There aren’t enough radiologists in India … you have the analysis done almost immediately, if you are connected, for a dollar .. we will see better results than a radiologist and way faster. Higher quality, faster, and dirt cheap. The radiologist couldn’t do a phone call for a dollar. What else do you need?”
• “There’s no reason an oncologist should be a human being. The right kind of oncologist isn’t the research oncologist. They know the most, but the guys who know how to take care of a patient are the community oncologists in Fresno or Stockton. They cannot always read all these journals, but they care for patients … They can be assisted with a virtual tumor board or an AI oncologist.”
• “Watson could do AI. IBM has the scientific talent to do AI, but they chose to package Watson and market it for what it wasn’t. I think they can do much more, but the early efforts have been less than successful because they over marketed its capabilities.”

A federal judge invalidates the expired patent of drug maker Allergan for dry-eye treatment drug Restasis, allowing the sale of generic products despite Allergan’s attempt to protect its patent by transferring it to an Native American tribe to shield it from administrative review. Allergan offered the St. Regis Mohawk Tribe $13.5 million upfront and $15 million per year as long as the tribe used its sovereign immunity to keep the patent intact, a tactic the judge slammed as a “scheme to evade their legal responsibility.”

Bloomberg reviews the history of short-term medical plans that would become legal to sell again under President Trump’s executive order, recalling that those policies generated a lot of patient lawsuits for refusing to cover the cost of pre-existing conditions. A woman bought a short-term policy to cover her between jobs, was diagnosed with breast cancer, and was left on the hook for the $400,000 treatment cost when the insurer refused to pay even though she wasn’t aware that she had cancer until after she signed up. An attorney of a patient whose insurer refused to pay for treatment of his newly diagnosed throat cancer said more insurance choices isn’t necessarily a good thing: “With insurance it, doesn’t work that way. You’ve got to put everyone in the same pot.” Everyone could save a fortune by buying barebones insurance (or none at all, for that matter) if only they had a functional crystal ball, but until that happens, health systems should assume they’ll be eating a lot more cost as patients who can’t afford the patient portion of their low-coverage insurance will still show up demanding care. My biggest frustrations in the insurance debate are: (a) lack of political will to look at provider and pharma costs means every solution is just another form of cost-shifting and rationing; and (b) politicians seem clueless about how insurance and charity care works in declaring that nobody should be forced to buy insurance they don’t need, raising the question of how they know they won’t need it or who pays for the care they will demand if they guess wrong.

I ran a sample quote for United Healthcare’s short-term medical insurance, assuming a 40-year-old, non-smoking resident of Chicago under today’s underwriting policies. The company’s best Golden Rule-issued plan would cost $94 per month and would carry a $10,000 deductible, 60/40 co-insurance, 20 percent co-pay, and a $10,000 out-of-pocket maximum. The maximum lifetime coverage is $2 million. All payments, including ED and hospital, require the insured to pay the $10,000 deductible. No prescription benefit is included, nor is any out-of-network coverage at all (I would probably buy relatively inexpensive travel insurance with medical coverage while traveling on business or on vacation). Pre-existing conditions aren’t covered at all, defined as those for which the insured sought diagnosis or care in the previous 24 months or if the insured had symptoms for which “an ordinarily prudent person” would have sought care in the previous 12 months (at least you know upfront if that’s you). The price is great, you get United’s much-lower negotiated prices instead of paying provider list prices for cash, and people who can absorb the financial risk will be OK as long as they don’t get a new diagnosis of a chronic disease. Those with any existing or newly diagnosed chronic medical problems or who have less than $10,000 in liquid assets might not fare as well unless the ACA plans remain available so they can jump back in the next enrollment period (which isn’t really the way insurance is supposed to work).

EHR consultant Loretta Gallagher sues NYC Health + Hospitals, with a former IT director testifying that AVP Al Garofalo polled peers at a holiday party about which female consultant they would like to have sex with. The plaintiff sued NYC H+H last year, claiming her company was fired after she was refused to falsify a monthly Epic progress report as the CMIO ordered, although the health system’s OIG recommended her termination in 2015 after finding that her aunt – an HHC employee – improperly arranged to hire her and other family members.

Pretty funny.

Sponsor Updates

• Black Book names MModal the leading vendor in transcription technology solutions and services as well as a top industry disruptors and challenger.
• Spok welcomes 150 customers to its Connect 17 annual conference in New Orleans.
• Diameter Health posts a podcast titled “Quality Measures Past, Present, and Future.
• Meditech’s 6.1 and Client/Server EHR platform and portal earn Infoway’s certification for meeting standards in Canada. 
• Ability Network announces the top-performing home health agencies in its annual HomeCare Elite program.
• Agfa Healthcare releases “Enterprise Imaging crosses The Tipping Point – Episode 1.”
• Aprima will exhibit at the Academy of Integrative Pain Management Annual Meeting October 19-21 in San Diego.
• Besler Consulting will present at the MAPAM Annual Fall Conference October 23 in South Yarmouth, MA.
• CarePort will exhibit at the Florida Association of ACOs annual conference October 19-20 in Orlando.
• Clinical Architecture joins the AMA’s new Integrated Health Model Initiative.
• The Jacksonville Business Journal recognizes CSI Healthcare IT CEO Rafe Sanson as a 2017 Ultimate CEO.
• Direct Consulting Associates and Dimensional Insight will exhibit at the HIMSS Midwest Fall Conference October 22-24 in Indianapolis.

Blog Posts

• Denials Management: Going from Zero to Hero (Impact Advisors)
• Alert Fatigue is an Alarming Problem (Optimum Healthcare IT)
• Understanding Customer Experience at Diameter Health (Diameter Health)
• Epic’s Revenue Guardian (Culbert Healthcare Solutions)
• Learning from Life’s Teaching Moments (Access)
• 3 strategies for success in the rapidly changing home care landscape (Meditech)
• Using Technology to Build an Integrated Practice #1 & #2 of 6 (AdvancedMD)
• NAACOS Wrap Up (Arcadia Healthcare Solutions)
• Will new identify-proofing NIST standards prove who you say you are? (Datica)
• ePractical Analysis: How Statistics Help Us See the “Gray” (Dimensional Insight)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 10/16/17

Top News

President Trump continues the dismantling of his predecessor’s programs without Congressional involvement by signing an executive order that would prohibit HHS from paying legally required (but also legally challenged) premium-lowering payments to insurers.

A CBO report from August predicted that such an order would increase premiums 20 percent immediately and increase the federal deficit by $194 billion over ten years, but would not significantly increase the number of people without insurance.

The immediate effect on the open enrollment period that starts in just over two weeks will vary by insurer and state. Some insurers built the expected action into their new premium prices, others advised insurers to assume the payments would be made in setting their prices, and the timing of the executive order makes it unlikely that insurers can get re-filed rates approved before enrollment begins, raising the possibility that they will pull out of the market.

Eighteen states have sued the White House over the executive order.

HHS Acting Secretary Eric Hargan and CMS Administrator Seema Verma release a statement supporting the order and criticizing the laws they swore to uphold, saying that “Obamacare is bad policy” and that cost-sharing reduction payments were authorized in an unlawful “unconstitutional executive action” (which is arguably true and the subject of the legal challenge).

Reader Comments

From Faith-Based Hill: “Re: Outcome Health. Overstating claims and fudging numbers will get you hundreds of millions in investment that you can use to buy time to hopefully turn things around. Too often the poor schmucks who try to build legitimate, ethical business get no such boost. The VC/PE world is ripe for such perverse incentives. A $5.5B valuation for putting TVs in doctors’ offices so Rx companies can prey on (cough, cough) I mean advertise to patients? How is this innovative? How is this going to actually benefit patients, lower costs, and (as their name ironically suggests) really improve outcomes? Sorry for ranting, but these Theranos-esque shysters make EHR vendors look like friggin’ Mother Teresa by comparison.” I’ll be interested to see how Outcome Health, as a privately held company, proceeds and how investors and customers react. Companies usually fire a few mid-level executive serving as scapegoats (giving them big go-away money and an ironclad NDA to prevent them from saying what really happened); apologize; and claim that the public penance marks a new chapter in the newly reinvented company’s inevitable destiny. The worst thing about Outcome’s business model of promoting drugs to patients at their vulnerable moments is that it works – doctors naively think they are immune from pharma propaganda and irrational patient pressure, but prescribing data proves otherwise. The most important “outcome” is boosting pharma’s bottom line. It’s distasteful to be reminded constantly that healthcare is like all other industries in being driven almost exclusively by profits, which was inevitable going back to the 1960s, when Medicare made the potential economic scale interesting to investors.

From Desperado: “Re: Cerner. Next CEO is … Zane Burke.” Unverified, but hardly shocking if true. CERN shares appeared (from my quick graph look) to have hit an all-time high after a nice run-up last, week, closing Friday at $73.57 as the company’s market cap approaches $25 billion. I’m happy that Burke at least earned an advanced degree (MBA) since so many healthcare executives rose through the sales ranks where graduate education is seen as a waste of time.

From ImageEnabler: “Re: Philips. Now requiring customers migrating away from their iSite PACS solution to use their third-party migration vendor of choice. Who owns the data again?” Unverified.

From Dr. Trump: “Re: ACA. Will Trump’s repeal of the health insurance subsidies and encouraging cheap individual health plans benefit Oscar Health, Joshua Kushner’s startup?” I expect so. The struggling Oscar was on the wrong side of Trump’s ACA wrath when he was elected since the company sold ACA plans, but it announced in April that it would start selling the kind of individual plans that will probably gain business from the executive order.

HIStalk Announcements and Requests

Incumbent HHS Secretary “None of the above” remains the favored candidate of poll respondents, although readers expressed tepid enthusiasm for having HUD Secretary Ben Carson swap chairs.

New poll to your right or here: what is the clinical and healthcare business impact of not having a national patient identifier?

This Week in Health IT History

One year ago:

• Allscripts acquires CarePort.
• AHIMA announces its plans to offer a health informatics certificate.
• The Internet goes dark in many parts of the country when hackers hit DNS routing company Dyn.

Five years ago:

• Wolters Kluwer announces that it will acquire Health Language.
• NYC H+H’s board minutes explain why it chose Epic to replace QuadraMed CPR, a decision that led Allscripts to sue the health system for giving Epic the bid in what it claimed was improper procurement.
• Google shares drop sharply when its financial printing firm releases the company’s SEC Form 8K in the middle of the day instead of after hours.
• An IOM report finds that a health system co-managed by the DoD and VA s is spending an extra $700,000 per year for pharmacists to enter prescription data, required because their separate EHRs cannot create a sequential prescription number.

Ten years ago:

• Medsphere settles its $50 million trade secrets and contract breach lawsuit brought against founding brothers Scott and Steve Shreeve.
• Eclipsys announces plans to move its headquarters from Boca Raton, FL to Atlanta.
• A Misys report concludes that doctors don’t use EMRs because they are expensive and hard to use.

Last Week’s Most Interesting News

• A Wall Street Journal report says that waiting room digital advertising company Outcome Health misled investors about its advertising performance as fresh investment sent its valuation soaring to $5 billion.
• President Trump signed an executive order that allows people to sidestep exchanges to buy less-expensive but less-comprehensive policies, a move that threatens to further destabilize ACA insurer risk pools.
• Express Scripts announces plans to acquire EviCore Healthcare for $3.6 billion.

Webinars

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester:  What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

October 24 (Tuesday) 1:00 ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 25 (Wednesday) 1:00 ET. “Delivering the Healthcare Pricing Transparency that Consumers are Demanding.” Sponsored by: Health Catalyst. Presenter: Gene Thompson, director, Health City Cayman Islands. Health systems are unlike every other major consumer category in not providing upfront pricing information. Learn how one health system has developed predictable, transparent bundled pricing for most major specialties. Attendees will gain insight into the importance of their quality measures and their use of actual daily procedure costing rather than allocated costs. They will also learn about the strategic risk of other market participants competing with single bundled pricing. The organization’s director will expand how its years-long process is enabling healthcare delivery reform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Sales

Pine Rest Christian Mental Health Services (MI) chooses Epic.

People

Former CMS Acting Administrator Andy Slavitt joins growth equity firm General Atlantic as special advisor, focusing on healthcare investments in underserved populations. HIStalk readers are cited in General Atlantic’s announcement for voting Slavitt as their “Healthcare IT Industry Figure of the Year” for 2016.

Announcements and Implementations

Hospital operator Mercy’s IT organization and device maker Medtronic will work together to capture de-identified data from heart failure patients to analyze their response to cardiac resynchronization therapy. Medtronic, based in Ireland after a controversial 2015 move of its US headquarters to Dublin to dodge US taxes, sells an implantable device that offers that therapy.

Government and Politics

Two senators write to President Trump to inquire why he declared on August 10, 2017 that “the opioid crisis is an emergency and I’m saying officially right now it is an emergency” without following through on the legal rather than the rhetorical declaration that is required to take federal action.

Privacy and Security

A Microsoft executive says that the government of North Korea was responsible for using stolen NSA tools to create the WannaCry malware that hit hospitals hard earlier this year.

Other

A 28-year-old New York man and self-described “serial data tracker” says his two-year-old Apple Watch saved his life by alerting him that his heart rate had jumped, which turned out to be a symptom of a pulmonary embolism that was successfully treated.

An 85-year-old New Hampshire pediatrician says the state is shutting her practice down for not using an EHR and therefore not checking the state’s doctor-shopper database before prescribing, although she fails to note that she willfully signed an agreement to close the practice after an investigation into poor documentation and questionable decision-making. The Poland-trained doctor claims that New London Hospital, with which she is affiliated, is trying to steal her patients. She doesn’t believe in technology:

I cannot practice medicine because the system practices with electronics. The computer is giving the diagnosis and telling them what medicine to prescribe. They practice medicine, and I practice medical art. They manage the patient, and I treat the patient … It’s fine if you are with the system. If you are not, you are an enemy of the system.”

Patients in England report that their doctors are ridiculing and threatening patients who research their issues on the Internet before a visit.

CNN finds that drug companies are making hundreds of millions of dollars each year – much of it paid by Medicare – on Nuedexta, intended for treating a relatively rare condition that causes laughing and crying in multiple sclerosis patients, but being aggressively marketed by salespeople for dementia patients in nursing homes. Its manufacturer has also paid many millions to doctors in honoraria and consulting fees, with doctors who have received those payments being responsible for nearly half of the Medicare claims paid for the drug. Nuedexta, which costs over $9,000 per year, contains two ancient, dirt-cheap drugs – dextromethorphan (in over-the-counter cough syrups) and quinidine sulfate (a bark-derived heart drug that’s so old that nobody can remember when it was first used). The unfortunately not-rare condition it causes rather than cures is excessive pharma laughing all the way to the bank.

A visitor is stabbed to death in his son’s hospital room at Johns Hopkins Hospital (MD), with police investigating a domestic issue trying to determine whether it was murder or suicide.

In India, a bystander captures on video a hospital dumping its medical waste into a river.

Weird News Andy is singing “Sole Man” while failing to identify a good ICD-10 code after reading this story. A man in England goes into cardiac arrest after swallowing a six-inch Dover sole, saved by a first responder who was able to remove the fish after six tries. The man claimed that the fish spontaneously leaped from the water into his mouth, but a friend told the first responder that the intrepid angler was fooling around by putting the just-caught fish over his mouth, only to be rendered speechless when it wriggled down his throat.

Sponsor Updates

• Harris Healthcare will exhibit at AHAAM’s Annual National Institute Conference October 18-22 in Nashville.
• Vocera will exhibit at the ANIA DFW Clinical Informatics Academy October 18 in Grand Prairie, TX.
• Black Book ranks ZeOmega number one for care management workflow applications, and includes it on its list of Top 50 Disruptive Health IT Companies.

Blog Posts

• How to Succeed in Sales as an Introvert (Salesforce)
• Healthcare Cybersecurity Needs Grow as Threat Levels Rise (The SSI Group)
• 5 “Silver Linings” of Patient Communications (Solutionreach)
• Relevant genetic test reporting: 3 essential tools (Sunquest Information Systems)
• Rising to the Challenge of Turning Data into Actionable Patient Intelligence (Surescripts)
• HEDIS 2018: tech specs on deck (Verscend Technologies)
• 2017 Innovator of the Year Award. (Voalte)
• Magnet Hospitals and Shared Governance: Empowering Frontline Nurses (Vocera)
• Why Not Make Every Day CX Day? (Plus 5 Tips to Get Started) (West Corp.)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 10/13/17

Top News

A Wall Street Journal report says that Chicago-based waiting room digital advertising company Outcome Health overcharged drug company advertisers by intentionally claiming an inflated number of screens in use, manipulating third-party ad performance analyses, and creating phony ad campaign screen shots.

The company, formerly known as ContextMedia Health, has placed three employees on paid leave pending an investigation.

A former executive who confronted co-founder and CEO Rishi Shah about questionable business practices lasted only two weeks, joining the seven executives who have left the company so far this year.

Chicago Mayor Rahm Emanuel helped dedicate a 29-story building that was renamed Outcome Tower in late September, the same day the company finalized plans to lay off 76 of its 600 employees.

Drug companies had previously obtained refunds from the company after their reps noticed that claimed devices in medical practices weren’t actually there. Outcome has also been accused of altering prescribing data from QuintilesIMS to make its campaigns look more successful, which earned Outcome a scolding from IMS.

Outcome Health’s last fund-raise valued it at $5 billion, making co-founders Rishi Shah and Shradha Agarwal, aged 31 and 32, respectively, paper billionaires.

Reader Comments

From Kyle vs. Givenchy: “Re: Athenahealth. Per the KLAS report, 13 of 28 Athenahealth customers have delayed or cancelled go-lives, not the 20 claimed. Seven of eight reported pharmacy-related issues, while end users are less enthusiastic than executives.” Unverified. I don’t see KLAS reports since they quit sending them to me, so I’ll take your word for what it found.

From Jake Asp: “Re: telemedicine. I didn’t see this news item mentioned.” I rarely mention telemedicine news because it has nearly zero to do with health IT. Talking to a doctor over a video connection is no different than calling them up on the telephone and that’s not going to get health IT geeks excited. I’m puzzled by health IT sites fawn over virtual visit news or proposed telehealth regulatory changes, maybe because those topics are easy for inexperienced people to write about. I go off-topic only (sometimes wildly) when I read something that I think will interest my peers and even then it’s only a tiny blurb rather than a padded-out article.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Change Healthcare. The new, Nashville-based, 15,000-employee Change Healthcare — one of the largest independent technology companies in the US — includes most of the former McKesson Technology Solutions as well as the former Emdeon, which was renamed Change Healthcare when Emdeon acquired that company in September 2015. The company serves payers (Intelligent Healthcare Network for financial and administrative transaction processing); providers (eligibility, claims, productivity, imaging, clinical workflow, and value-based care); and consumers (True View Health Shopping Platform). The company just announced healthcare’s first enterprise blockchain solution. Thanks to Change Healthcare for supporting HIStalk.

Listening: new from the amazing Michigan-based hip-hop artist NF (born Nathan Feuerstein), whose hard-hitting yet non-explicit lyrics allow focusing on the anger and self-doubt he describes rather than the usual vapid, misogynistic swagger. The 26-year-old wrote about his mother’s drug overdose death in “How Could You Leave Us?”: “I don’t get it mom, don’t you want to watch your babies grow?; I guess that pills are more important, all you have to say is no; But you won’t do it, will you? You gon’ keep popping ’til those pills kill you; I know you gone but I can still feel you.” His long tour that starts in January includes a lot of stops in health IT centers like Nashville, Atlanta, Raleigh, Boston, Madison, and Kansas City. I’m also enjoying questionably named but inarguably talented Wales-based hard rockers Catfish and the Bottlemen.

This week on HIStalk Practice: Lightbeam Health Solutions will provide population health management solutions to American College of Osteopathic Family Physicians. In the Consultant’s Corner, Brad Boyd offers tips to help practice administrators proactively address physician burnout. Azalea Health merges with Prognosis Innovation Healthcare. Vermont physicians face criticism as medical marijuana clinics attempt to take off. ZDoggMD brings the house down at MGMA. Follow-up study shows PCP antibiotic overprescribing habits could benefit from “nudges.” Hope Orthopedics of Oregon kicks off patient-reported outcomes program. Formativ Health helps independent MDs in Pennsylvania transition to value-based care.

Webinars

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester:  What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

October 24 (Tuesday) 1:00 ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 25 (Wednesday) 1:00 ET. “Delivering the Healthcare Pricing Transparency that Consumers are Demanding.” Sponsored by: Health Catalyst. Presenter: Gene Thompson, director, Health City Cayman Islands. Health systems are unlike every other major consumer category in not providing upfront pricing information. Learn how one health system has developed predictable, transparent bundled pricing for most major specialties. Attendees will gain insight into the importance of their quality measures and their use of actual daily procedure costing rather than allocated costs. They will also learn about the strategic risk of other market participants competing with single bundled pricing. The organization’s director will expand how its years-long process is enabling healthcare delivery reform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Atlanta-based ambulatory EHR/PM vendor Azalea Health acquires community hospital EHR vendor Prognosis Innovation Healthcare, which was known as Prognosis Health Information Systems until it was renamed in 2014 by its new private equity owners. I interviewed Ramsey Evans, then CEO of Prognosis, way back in September 2010. He left the company in 2013 to return to Keais Records Retrieval as CFO and board chair – the Houston-based company offers electronic medical records retrieval for attorneys.

Consumer health benefits and wellness technology vendor Welltok acquires Tea Leaves Health, which offers consumer and physician relationship management systems. Ziff Davis, which bought 60-employee, Atlanta-based Tea Leaves for $30 million in 2015, sold it to Welltok for $83 million. Ziff Davis is owned by Internet company J2 Global, which also owns Everyday Health (MedPage Today, KevinMD.com and MayoClinic.org). ZD said in February 2017 that Tea Leaves might never make a profit.

The private equity owner of revenue cycle technology vendor Practice Insight sells the business to an unnamed buyer.

Wellness app vendor StayWell, a subsidiary of drug maker Merck, acquires MedHelp’s health engagement platform. Meanwhile, health shopping site operator Vitals buys MedHelp’s online health communities business.

Sales

North Carolina Hospital Association chooses PatientPing to offer statewide, real-time care coordination.

Announcements and Implementations

Cerner tells its user group attendees that it will continue to offer free CommonWell services through 2020.

Flirtey, which uses drones to deliver emergency medical supplies, will send automated external defibrillators in response to 911 cardiac arrest calls received by northern Nevada emergency medical provider REMSA. 

Summit Healthcare chooses system integrator Speedum Technologies Health Solutions to resell its integration platform, scripting tool, and downtime reporting system.

EClinicalWorks will partner with clinical data registry and analytics vendor FIGmd to offer its EHR users connectivity to specialty registries.

Government and Politics

President Trump takes another step to kill the Affordable Care Act by signing an executive order that will make it easier for small businesses and perhaps even individuals to band together to buy health insurance across state lines (which is already legal but rarely done since it’s hard for insurers to create networks in new states and such sales require state-by-state approval). The order will also again allow the sale of short-term policies that don’t cover pre-existing conditions, which the ACA halted. Critics worry that cheap but low-quality plans will draw healthy people away from ACA plans, driving up premiums as sicker people are left without alternatives. Health systems will be watching the change in their patient bases closely. ACA expert Charles Gaba’s expert analysis is sobering and is a reminder that “slicing up the risk pool does absolutely nothing to lower the total cost of healthcare.” HHS will be responsible for setting definitions in drafting the legislation, which will likely take several months if the order survives the inevitable legal challenges.

Privacy and Security

A security researcher finds that the website of Equifax – fresh off its massive breach that exposed the information of 146 million people – was hacked this week, with visitors being tricked into installing an adware-pushing app posing as an update to Adobe Flash.

Other

Paul Purcell, administrator of STEP Pediatrics (TX), reports that Memorial Hermann some doctors are going back to paper after a nine-day performance problem caused by an EClinicalWorks upgrade.

An interesting review by Pew Charitable Trusts finds that a remarkable number of Americans use life-sustaining technologies in their homes and are thus vulnerable to storm-related power outages. HHS mined its Medicare claims database to create a map of people who had received government-provided medical equipment to help health officials locate them in an emergency.

In a PR move that always strikes me as a self-serving form of cost-shifting, at least one Las Vegas hospital and two ambulance services announce that they will not charge victims of the recent mass shooting for the services they received. Other patients whose circumstances were judged as less meaningful will have to cover the cost of the non-profit largesse, which would ring truer if the organizations just did it without crowing.

A Harvard Business Review article by two Bain & Company’s healthcare partners cites surveys suggesting that doctors understand that the cost of drugs and clinical care are too high, but that nobody’s inviting them to the table to figure out how to control costs, improve performance, or move to new reimbursement models.

Analysis finds that dialysis operator DaVita makes more than half its profit from patients who receive charity help to pay their insurance premiums, with 13 percent of its patients receiving help from the American Kidney Fund to which DaVita makes tax-free donations. The company benefits because private insurance pays more than Medicare or Medicaid, with charity-funded insured patients contributing $540 million to the company’s annual profit.

The hospitals in Ontario’s largest network are reviewing five million electronic patient records after a patient-reported error leads them to discover a few incorrect records.

Count me in for a comprehensive $3,300 report on the “HER” market, as it’s referred to 25 times in the announcement without the sharp-eyed editors noticing their mistake. Adding to my interest is that the company’s address from which a wide variety of crappy reports emanate is — like the addresses of some of its 25 associated publishers — a house in a residential neighborhood. The report description is loaded with fractured English as a second language, but I’ll focus on “till,” best used as a synonym for “cash register” or as a verb referring to “plow” rather than a sloppy substitute for “until.”

Ross Martin, MD and his The American College of Medical Informatimusicology debuts his new song “DigituRN” at the Tri-State Health Informatics Summit this week. The term refers to transforming the nursing profession through informatics and digital innovation.  

Weird News Andy likes that several animation studios worked with the Pediatric Brain Tumor Foundation for free to create short videos explaining procedures and conditions to children, a project they call Imaginary Friend Society.

Sponsor Updates

• MedData and Experian Health will exhibit at the TAHFA & HFMA South Texas Fall Symposium October 15-17 in San Antonio.
• Meditech will host the 2017 Physician and CIO Forum October 18-19 in Foxborough, MA.
• Navicure will exhibit at the Raintree User Conference October 16-18 in San Antonio.
• Health Catalyst is named as the 17th fastest-growing company in Utah, with sales growing 1,700 percent in five years.
• National Decision Support Co. and Parallon Technology Solutions will exhibit at the Meditech 2017 Physician and CIO Forum October 18-19 in Foxborough, MA.
• Netsmart will exhibit at the National Association for Home Care and Hospice Conference October 15 in Long Beach, CA.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Washington State AWHONN Conference October 15-17 in Lake Chelan, WA.

Blog Posts

• MACRA for Small Practices (Optimum Healthcare IT)
• Update the Look of Your TMS Site (Learn on Demand Systems)
• Refine Your Outstationed Worker Program to Deliver Reliable Cash Flow (MedData)
• How to find the “human moments” in EHR implementation (and other lessons) (Nordic)
• Learning from Life’s Teaching Moments (Access)
• Next Wave’s Greg Walton Named Life Member of HIMSS (Huntzinger Management Group)
• Don’t Let Your Revenue Cycle Be Unlucky This Friday the 13th (Navicure)
• Improving Mental and Emotional Wellness (Netsmart)
• Bad Ass Women in Health Tech: Heather Bowerman (Redox)
• Save Your Data (and Your Budget) from Cyberattacks (CloudWave)
• Four Questions Series: Kevin Hutchinson, Founder & CEO, MyTaskit, PatientPing Advisor (PatientPing)
• Disrupt Away (PatientKeeper)
• Tips for Structuring a Successful Device Pilot (PerfectServe)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 10/11/17

Top News

Pharmacy benefits manager Express Scripts will acquire care management vendor EviCore Healthcare for $3.6 billion.

Private equity firm General Atlantic formed EviCore in 2014 in merging its acquisitions CareCore (acquired in January 2014 for an undisclosed price) and MedSolutions (acquired in November 2014 for a reported $1 billion). The company renamed itself to EviCore in June 2015. 

EviCore was rumored to be seeking a buyer in May 2017 in hoping for a valuation of more than $4 billion, but was simultaneously planning an IPO in case no acceptable offers were made.

EviCore Chairman and CEO John Arlotta has worked for General Atlantic and was previously president of Express Scripts competitor Caremark RX (now CVS Caremark).

HIStalk Announcements and Requests

Every October Lorre offers a deal for new HIStalk sponsors – sign up now and get the rest of 2017 free. Contact her if you want in before the usual pre-HIMSS rush that, shockingly, will be here before we know it.

I wanted to buy a baby monitor for some relatives who are new parents and ran across this IP-based camera that was so cool I had to get myself one afterward. The TenVis HD camera features two-way audio, rotation, night vision with 32-foot range, a micro SD card slot for recording, optional emailing of a snapshot or a telephone alert when it detects movement, and an app that allows viewing real-time video from anywhere. That’s a lot of technology in a $40 device. Setup was nearly instantaneous over WiFi, although I had to throttle back my router to 2.4 GHz for configuration and then switch it back to 5 GHz afterward because of some quirk. I don’t need to monitor babies, but it’s fun to check out what’s happening in the living room from anywhere in the house or anywhere in the world, while other Amazon reviewers love it for keeping an eye on elderly parents or driving their dogs crazy by talking to them from afar. My gift recipients report an added benefit that I hadn’t thought of – they’ve given the far-away grandparents access so they can take a wistful look at the little one whenever they want.

Webinars

October 17 (Tuesday) noon ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester:  What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Telahealth technology vendor Avizia acquires Seattle-based virtual clinic operator Carena.

Pittsburgh-based AI vendor Petuum — which  is developing  products for several industries including an EHR-powered disease and treatment module — receives a $93 million investment, increasing its total to $108 million. Two of the three founders earned PhDs from Carnegie Mellon University in computer science and machine learning, respectively.

Sales

Aetna selects Stanson Health to automate its clinical prior authorization process by integrating with provider EHRs to collect both discrete and free-text information.

Southwestern Health Resources (TX) chooses Phynd’s provider management system that will integrate with its Epic and credentialing systems, managing 50,000 providers in 31 hospitals.

People

Chris Mathia (Hyland) joins Innara Health as EVP of sales.

Announcements and Implementations

Clinical Architecture releases version 2.0 of its Symedical enterprise terminology management platform.

EClinicalWorks announces that its EHR now supports the OpenNotes initiative in allowing clinicians to share visit notes with patients via its patient portal.

Nokia will cease development of its $45,000, 360-degree Ozo virtual reality camera for filmmakers, saying that the VR market is developing more slowly than the company expected. Nokia will focus on digital health, enabled by its June 2016 acquisition of France-based consumer medical gadget vendor Withings for $191 million.

HIMSS Analytics launches a mobile version of its Logic database, giving health IT salespeople access to information about provider organizations and their technology-related activities.

Switzerland-based Ascom releases Digistat Vitals, which allows bedside EHR entry of vital signs and clinical scores in eliminating double entry and paper transcription.

PatientKeeper announces a hosted version of its physician charge capture solution.

Government and Politics

A study finds that the FDA‘s requirement that direct-to-consumer drug advertisements list side effects paradoxically increases sales of potentially dangerous drugs. The “argument dilution effect” leads consumers to assume that the mandatory long list of possible side effects – some of them included because of frequency of occurrence rather than severity – misleads them into thinking a drug isn’t likely to harm them.

A former Missouri nursing home company CEO is sentenced to 41 months in prison and ordered to pay $667,000 in restitution for using Medicaid payments to pay for strippers, casinos, and country clubs as residents of his facilities were given clear broth as meals and did not receive their meds because the company failed to pay its pharmacy provider.

Privacy and Security

Security researchers find an unsecured Amazon Web Services S3 file containing the medical information of 150,000 people, apparently patients of anticoagulant monitoring company Patient Home Monitoring Corporation.

In a related item, another security firm finds four unsecured, Accenture-owned AWS S3 buckets holding customer decryption keys, passwords, and certificates. Ironically, the exposed information includes software for Accenture Cloud Platform, the company’s enterprise cloud offering.

Technology

A Wall Street Journal review of scientific studies confirms my suspicion that smartphones make their users stupider. Not only do phones distract people from real-world tasks (the average phone user whips theirs out 80 times per day), keeping a phone “nearby and in sight” diminishes the ability to learn, reason, and solve problems even as users suffer from “delusions of intelligence” in confusing what they actually know vs. what they can look up on their phones. The article notes,

It isn’t just our reasoning that takes a hit when phones are around. Social skills and relationships seem to suffer as well. Because smartphones serve as constant reminders of all the friends we could be chatting with electronically, they pull at our minds when we’re talking with people in person, leaving our conversations shallower and less satisfying … The evidence that our phones can get inside our heads so forcefully is unsettling. It suggests that our thoughts and feelings, far from being sequestered in our skulls, can be skewed by external forces we’re not even aware of … A quarter-century ago, when we first started going online, we took it on faith that the web would make us smarter: More information would breed sharper thinking. We now know it isn’t that simple. The way a media device is designed and used exerts at least as much influence over our minds as does the information that the device unlocks.

In England, the local paper covers the use by King George Hospital of Vitalpac, an iPad-based vital signs documentation system from System C Healthcare that has reduced hourly rounding time by 75 percent. McKesson bought England-based System C for $140 million in 2011, then sold it to private equity form Symphony Technology Group in 2014 as McKesson began its health IT exit.

Other

Two Northern California hospitals – Santa Rosa Memorial and Queen of the Valley Medical Center — evacuate patients after Wine Country wildfires spread to 100,000 acres, burning down 1,500 buildings and killing a least 11 people. If there’s such a thing as wine futures, now would be a great time to load up.

A. James Bender, MD, medical director for clinical informatics at Virginia Mason (WA) and his Virginia Mason Center for Health Care Solutions co-author write in Harvard Business Review that the EHR is increasing innovation, with these examples:

• Alerting clinicians about possible omissions in care based on evidence.
• Adding transparency to patient and family engagement with ICU electronic patient scoreboards to prevent blood clots.
• Providing intelligence, such as auto-ordering of labs when specific drugs are ordered.
• Blocking orders for high-cost imaging studies that are not supported by evidence.

The local paper reports that three-hospital Maui Health System (HI) has experienced a few technology problems in the first 100 days of turning over operation of the to Kaiser Permanente. Community-based doctors say they don’t automatically receive faxed information about the hospital visits of their patients like they used to, causing billing delays.

The Salt Lake City, UT police chief fires the detective who handcuffed an ED nurse who refused to allow him to draw a blood sample from a patient without obtaining a warrant as hospital policy requires.

The work of Richard Thaler, who just won the economics Nobel  prize, has healthcare implications. His specialty is behavioral economics, which studies why people act irrationally when it comes to money, why they fail to stick with their plans, and how they choose whether to act selfishly or selflessly. He says people segregate money in mental accounts and it’s easier for them to spend someone else’s money. He also urges organizations and government to nudge people to help them make good decisions, which would make his observations on the US healthcare system interesting. He said previously that employer healthcare insurance sites are too complicated, such as displaying deductibles as a full-year sum while pricing premiums by the paycheck. One of his significant contributions involved 2006 federal retirement savings plan changes that encouraged employers to make participation opt-out rather than opt-in, which doubled participation, although he’s disappointed that companies encourage under-contribution by setting the default contribution at the minimum amount instead of escalating it over time.

A woman in Japan posts Instagram-worthy photos of the hospital meals she was served following the birth of her child, making it obvious that they do things differently there. 

Sponsor Updates

• Colquitt Regional Medical Center (GA) describes the benefits it has seen from its summer 2016 go-live on Meditech 6.1.
• Fortified Health Security President Dan Dodson will present “Out of the Dark: Seeing and Securing Network-Connected Medical Devices” at the Raleigh Health IT Summit on October 20.
• Aprima will exhibit at the American Academy of Home Care Medicine Annual Meeting October 13-14 in Rosemont, IL.
• Besler Consulting will present at the SC HFMA Fall Institute October 12 in Greenville.
• Black Book publishes the results of its annual outsourced coding and HIM market client experience surveys.
• CoverMyMeds partners with Pelotonia to raise over $100,000 for cancer research.
• CTG will exhibit at the Northwest Arkansas Technology Summit October 17 in Rogers.
• Direct Consulting Associates, Imprivata, and InterSystems will exhibit at the Health Connect Partners Hospital & Healthcare IT Conference October 18-20 in Chicago.
• Dimensional Insight will exhibit at the HFMA Region 2 meeting October 18 in Verona, NY.
• FormFast will exhibit at the ASHRM Annual Conference & Exhibition October 15-18 in Seattle.
• Healthwise will exhibit at Philips Connect2Care October 16-18 in Los Angeles.

Blog Posts

• The Right Stuff for Improving Compliance With Joint Commission Communication Goals (Spok)
• Top Three Lessons to Learn Before an EHR Go-Live (Leidos Health)
• Bariatric Beds as a Barrier to Discharge (CarePort)
• Physician Satisfaction Survey Shows Impact of Work Environment (CareSync)
• Building a Better Product (Clinical Architecture)
• Healthcare’s Hierarchy of Location Needs (CenTrak)
• Advancing Your Practice’s Technology Can Help Boost Practice Value (ChartLogic)
• The Debate Continues Over Healthcare Reform (Dynamic Computing Services)
• A Cool Tool for Experimenting with Dashboard and Portal Color Schemes (Dimensional Insight)
• What’s the “Now and the Next” CDS and EHR? (Elsevier Clinical Solutions)
• The lesson of Dallas: A change in thinking (EClinicalWorks)
• The Successful Startup That’s Two Decades Old (Healthgrades)
• Key Steps that Help CIOs Better Manage M&A Change (Huntzinger Management Group)
• Marketing Statistics That Matter to Healthcare (Influence Health)
• First Rule to Member Engagement: Remember that No One Asked for Amazon Prime (InstaMed)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
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